Abstract
More than 100 years of research has now been conducted into the prevention, control and elimination of rabies with safe and highly efficacious vaccines developed for use in human and animal populations. Domestic dogs are a major reservoir for rabies, and although considerable advances have been made towards the elimination and control of canine rabies in many parts of the world, the disease continues to kill tens of thousands of people every year in Africa and Asia. Policy efforts are now being directed towards a global target of zero human deaths from dog-mediated rabies by 2030 and the global elimination of canine rabies. Here we demonstrate how research provides a cause for optimism as to the feasibility of these goals through strategies based around mass dog vaccination. We summarize some of the pragmatic insights generated from rabies epidemiology and dog ecology research that can improve the design of dog vaccination strategies in low- and middle-income countries and which should encourage implementation without further delay. We also highlight the need for realism in reaching the feasible, although technically more difficult and longer-term goal of global elimination of canine rabies. Finally, we discuss how research on rabies has broader relevance to the control and elimination of a suite of diseases of current concern to human and animal health, providing an exemplar of the value of a ‘One Health’ approach.
Highlights
For thousands of years, people have lived in fear of rabies transmitted from domestic dogs, and more than half of the world’s population still do so today
Many mammalian hosts can be infected with the rabies virus, the domestic dog remains to this day by far the most important species causing human rabies deaths and tens of thousands of people die from canine-mediated rabies each year [3,4], mostly in Asia and Africa where the disease is maintained in domestic dog reservoirs
We address the reasons why, despite the long history of rabies research and earlier successes in canine rabies elimination, new research has been needed to tackle the problem of rabies in low- and middle-income countries (LMICs) of Africa and Asia
Summary
People have lived in fear of rabies transmitted from domestic dogs, and more than half of the world’s population still do so today. Many mammalian hosts can be infected with the rabies virus, the domestic dog remains to this day by far the most important species causing human rabies deaths and tens of thousands of people die from canine-mediated rabies each year [3,4], mostly in Asia and Africa where the disease is maintained in domestic dog reservoirs. The need for and feasibility of rabies elimination through interventions in the dog population has been recognized for more than a century. We demonstrate how research has generated optimism about the feasibility of achieving global targets of zero human deaths from dogmediated rabies, guided pragmatism in the design of dog vaccination strategies. In LMICs, and instilled realism in the path towards global canine rabies elimination
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