One Health Approach: The Need of the Hour
1Ms. Sanskruti Sunil Salutgi*, 2Dr. Pragati Sunil Salutgi
1Undergraduate Scholar, Apollo College of Veterinary Medicine, Jaipur, Rajasthan,302031 India.
2Post Graduate Scholar, Department of Veterinary Medicine, Mumbai Veterinary College, Mumbai, Maharashtra, 400012, India.
*Email: work.sanskrutisunil@gmail.com
Rabies is a viral zoonotic disease of utmost public health importance due to its lethality. It is among the few neglected tropical diseases having a vaccine although, it poses as a classic One Health challenge. The disease is primarily transmitted by dogs and can be combatted by Canine Rabies Vaccination and One Health approach as demonstrated by Canada, Western Europe, America, Mexico, Japan and Latin America. The concern although, is the accessibility of the vaccine, pre-exposure prophylaxis to dogs and post exposure prophylaxis to the bite victims in middle and low-income countries like Asia and Africa. As per WHO, the South East Asian countries contribute to two third of the total global dog mediated rabies deaths. Rabies is endemic in India except Andaman and Nicobar, and Lakshadweep Islands and accounts for one-third of global mortality mediated by dog bites.
One Health Approach aims at achieving optimal health outcomes by evaluating the connection between people, animals, plants and their shared environment. Concerted efforts for prevention, control and elimination of rabies have been put in by World Health Organisation (WHO), Food and Agriculture Organisation and World Organisation for Animal Health (OIE). They have declared elimination of dog mediated Rabies deaths by 2030. The One Health Approach is also consistent with Sustainable Development Goal (SDG) 1 and a part of 2 that is ending poverty in all forms and zero hunger respectively.
The most effective strategy for eradicating rabies has been the One Health concept, which has been implemented by many nations. The goal of eliminating rabies can only be accomplished with the consistent and coordinated political commitment and administrative assistance of all stakeholders, from the highest level down to the village level. Utilizing the experience of interested stakeholders from various sectors, the One Health Approach is a widely accepted method and a logical approach for addressing complicated problems and challenges. Due to different administrative structures and agendas across sectors involved at the national and sub-national level, the prevention and control of rabies under the “One Health Approach” is also difficult in the Indian context as:
- India has a large stray population.
- Limited logistics and poor supply chain management.
- Imperfect awareness among working professionals and general public.
- Inadequate surveillance and record keeping in reported cases in veterinary and human health sector.
- Poor resource allocation for achieving target.
For Rabies Elimination, a One Health approach has been conceptualised after considerable consultation from stakeholders and recommendations by various organizations like WHO, OIE and GARC (Global Alliance for Rabies Control). The National Action Plan for Dog mediated Rabies Elimination (NAPRE) aims to reduce and eliminate human rabies via mass dog vaccination and proper post-exposure treatment. The key principles of NAPRE are:
1) Prevention: Accessibility, affordability and availability of economical post-exposure prophylaxis to the victims.
2) Promotion: Increase awareness about the disease via education and research.
3) Partnership: Assist anti-rabies drives by involving proactive advocates from communities, urban and rural civil societies and overseas partners.
Strategies adopted by NAPRE to fight rabies consists of human health and animal health component. They are as follows:
The Human Health Component:
- Availability of Anti Rabies Vaccine (ARV) and Anti Rabies Serum (ARS) to all human victims across all health facilities.
- Training and building a team of animal bite management professionals.
- Encouraging pre-exposure prophylaxis in vulnerable groups.
- Enhancing surveillance of animal bites and Rabies cases in humans.
- Improving diagnostic procedures and capacity.
- Promoting research on rabies.
- Aligning Veterinary and Medical sectors for collaborative benefits of joint responses.
- Involving NGOs and community organisations via public-private partnership.
The Animal Health Component:
- Estimating Canine Population.
- Identifying Rabies risk zone.
- Planning and implementing mass dog vaccination programme.
- Evaluating post vaccine coverage.
- Managing dog population.
- Promoting responsible pet ownership.
Rabies is a preventable disease and can be successfully managed by the multi-sectorial One Health Approach and additional measures adopted by the country pertaining to it’s geography and socio-political situation.
