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September 23, 2019

Time to eliminate rabies

Rabies is preventable through vaccination and post-exposure immunization. Yet, nearly 70,000 people still die from the disease every year across the world, mostly in rural areas
With the opening of special care units for dog bites at the Yangon General Hospital, North Okkalapa People’s Hospital, and Thingangyun People’s Hospital, the number of deaths from rabies in Myanmar has reduced from 152 in 2014 to 71 in 2018.
Despite the downward trend in dog bite cases from about 15,000 a month in 2017 to 1,000 a month in 2019, the number of dog bites is still high. The Ministry of Health and Sports has spent about K15 billion in tackling the zoonotic disease from the 2016-2017 fiscal year to the 2018-2019 fiscal year.
The time has come to map dog-bite prone areas or townships, and to reinforce the fight against the rabies.
In fact, to tackle this disease, a multi-sectoral response is needed. Given that 99 per cent of human infections are acquired from dog bites, mass vaccination of dogs — combined with the management of stray dogs and responsible dog ownership — is the most cost-effective way to eliminate the disease.
Vaccinating 70 per cent of dogs can reduce human cases to zero, and the cost of dog vaccines is much lower than that of post-exposure prophylaxis for human beings.
Starting from 2013, about 150,000 dogs have been vaccinated on average per year. The vaccination campaign from 2019 to 2021 against dogs in Nay Pyi Taw, Yangon, Mandalay, Bago regions, and Rakhine State by the Four Paws International, in cooperation with the ministry to mark World Rabies Day, which falls on 28th September, bodes well for us.
According to a 2018 survey, there are over 4 million dogs in Myanmar, and this number is too high for our country. Nonetheless, if we ensure that human vaccines and immunoglobulin are affordable and accessible, we can reduce the fatality rate, which is almost 100 per cent if post-exposure prophylaxis is not given before symptoms develop. The education of local communities is also a key priority to ensure that people who get bitten seek prompt treatment.
To achieve a target of no rabies deaths by 2030, we must recognize that rabies elimination is a health priority.
Successful implementation of anti-rabies efforts will depend on political will, coordination between human and animal health sectors, support from donors and stakeholders in the public and private sectors, and community engagement. The time to act is now.

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