The World Organization for Animal Health (OIE) has released a statement emphasizing the importance of rabies vaccination in dogs. They state:
"Rabies is a neglected and severely under-reported zoonotic disease in developing countries, killing each year worldwide an estimated 50,000 to 60,000 people, mostly children with terrible suffering and a much higher number of animals… Eliminating rabies in dogs is the optimal control method for preventing spread of the disease."
They also say:
"Dog vaccination and stray dog population control are more efficient and cost effective that post bite treatment in humans."
As with many diseases, prevention is much more effective (and potentially cheaper) than treatment. As OIE Director General Dr. Bernard Vallat explains, "The cost of a post-bite treatment in humans is about twenty to one hundred times more costly than the vaccination of a dog. Currently with only 10% of the financial resources used worldwide to treat people after a dog bite Veterinary Services would be able to eradicate rabies in animals and thus stop almost all human cases."
I think that the sentiment is excellent; we need to focus on vaccination. However, the thought that we could eradicate rabies altogether seems a little optimistic and surprisingly naive. Eradication of a disease such as rabies that has multiple wildlife and stray animals as hosts is difficult, and bordering on impossible. Providing more money for vaccination is excellent, but one of the major problems with rabies control in developing countries is actually vaccinating the animals, even if lots of free vaccine is available. Dedicating personnel and logistical time and money for vaccinating dogs may not be high on the priority list in many countries with other major economic, social and healthcare system challenges. Catching and vaccinating all stray animals is not going to happen. Vaccinating as many animals as possible is important, along with stray animal population control, education of the public about bite avoidance, education of the public and healthcare personnel about bite treatment and prompt availability of adequate post-exposure treatment.
With a good medical and public health system and an informed population, rabies deaths could one day be few and far between. Emphasizing more money for vaccination in the absence of other efforts isn’t addressing the big picture. In a perfect world, we’d be able to vaccinate all animals – unfortunately, our world is far from perfect, and while thinking about best-case scenarios is good, we need to focus on what is practical and achievable. That involves more money for vaccination, along with broader approaches by groups such as Vets Without Borders.