RABIES: ALL FOR 1, ONE HEALTH FOR ALL
Theme: One Health Zero Deaths
Name- Ankit Kumar, Final year BVSc Student, VCRI Namakkal, TANUVAS
September 28 is World Rabies Day. Established in 2007, World Rabies Day aims to raise awareness about the world’s deadliest infectious disease and help the world come together to fight the disease. The theme for 2023’s World Rabies Day is “Rabies: All for One, One Health for All,” and focuses on:
- Continuing to work towards eliminating rabies around the world
- Embracing the One Health approach to rabies control, which means collaborating across human, animal, and environmental sectors
- Focusing on the “Zero by 30” goal to reduce rabies deaths in people to zero globally by 2030.
World Rabies Day, a global health observance started in 2007 to raise awareness and bring together partners to enhance prevention and control efforts worldwide.
World Rabies Day is an opportunity to reflect on how rabies impacts your community and other communities around the world. Rabies is still present in many parts of the United States, where it is mostly found in wildlife. Because of high vaccination levels in dogs and cats in the U.S., rabies in pets or other domesticated animals is relatively rare. However, rabies in dogs is common in many other countries. In fact, roughly a quarter of reported human rabies deaths among people in the United States result from dog bites they received during international travel. The best way to protect yourself, your family, and your pets is keeps dog and cats up to date on rabies vaccination.
While rabies is a 100% preventable disease, nearly 60,000 people die from the disease around the world each year. World Rabies Day is an opportunity to reflect on our efforts to control this deadly disease and remind ourselves that the fight against rabies is not yet over. Major health organizations including the Centres For Disease Control And Prevention (CDC), the United State Department Of Agriculture (USDA), World Health Organisation (WHO), the World Organisation For Animal Health (WOAH), and the Food And Agriculture Organisation Of United Nation (FAO) are working together to eliminate rabies deaths in people that are caused by dogs by 2030.
One Health’ is an integrated, unifying approach to balance and optimize the health of people, animals, and the environment. One Health involves the public health, veterinary, and environmental sectors. The One Health approach is particularly relevant for food and water safety, nutrition, the control of zoonoses (diseases that can spread between animals and humans, such as flu, rabies, and Rift Valley fever), pollution management, and combatting antimicrobial resistance. The new concept, “One World, One Health,” is based on the understanding that humans, animals, and the environment are inextricably linked, indicating that the world has suddenly realized the interrelation between ecology, animal diseases, and public health, striving to restore and maintain harmony and synergy.
ONE HEALTH APPROACH
Key components of a one health approach to rabies:
- Vaccination Programs: Mass vaccination of dogs: As the primary source of rabies transmission to humans, vaccinating dog is essential.
- Surveillance and Monitoring: Integrated Surveillance System. These systems help in early detection of rabies outbreaks in both animals and humans.
- Education and Awareness: Community engagement: One health encourages educating communities about rabies prevention, responsible pet ownership, and safe interactions with wildlife.
- Access to Post-Exposure Prophylaxis (PEP): Ensuring accessibility even in remote regions, to individuals bitten or scratched by potentially rabid animals.
- Research and Innovation: Collaborative research: Scientists from various disciplines collaborate to develop improved vaccines, diagnostic tools, and treatment options for rabies.
“One Health” has been defined by the WHO as “An approach to designing and implementing programs, policies, legislation, and research in which multiple sectors communicate and work together to achieve better public health outcomes.” The goal of One Health is achieving optimal health outcomes while recognizing the interconnection between people, animals, plants, and their shared environment.
One Health is concerned with multiple issues which include zoonotic diseases, antimicrobial resistance, food safety and food security, environmental contamination, vector-borne diseases, and other health threats shared by people, animals, and the environment. Several other fields are indirectly affected and would also benefit from One Health approach such as injury, occupational health, and non-communicable diseases. Rabies is a classical one health challenge wherein more than 99% of deaths arise from exposure to a rabid dog. Rabies is a fatal but preventable viral disease. It can spread to people and pets if they are bitten or scratched by a rabid animal. In US, rabies is mostly found in wild animals like bats, racoons, foxes, but in our country, dogs carry rabies and most rabies death in people around world are caused by dog bites. The rabies virus affects central nervous system.
Definitions of One Health
There are several definitions of One Health. Some of these are:
One Health is a multi-sectoral, interdisciplinary, and collaborative approach to attain optimal health for animals, the environment, and humans (CDCP, 2020). One Health can provide a framework for national authorities to understand and implement it for improved connectivity and collaboration among various stakeholders.
World Bank describes One Health as: A framework for enhanced collaboration in areas of common interests (intersections), with initial concentration on zoonotic diseases, that will reduce risk, improve public health globally and support poverty alleviation and economic growth in developing countries (World Bank, 2020).
One Health, broadly, can also be defined as ”the collaborative efforts of multiple disciplines working locally, nationally, and globally to attain optimal health for people, animals, and our environment (AVMA, 2020).” Barriers to implement One Health offers an approach to yield added value from the collective strengthening of human, animal, and environmental health systems to enable their coordination and collaboration to address threats at the human-animal-environment interface for effective prevention, detection, response, and recovery. All One Health definitions enunciate prevention, diagnosis, response, and recovery from events influencing human and animal health through strengthening of sector specific capacity by major sectors and amplifying their impact through essentiality of inter-sectoral collaboration. Basic tenets of One Health is to strengthen core capacity in every sector that has a bearing upon prevention, detection, response and recovery to zoonotic infections and AMR, and assure a sustainable, strong, beneficial, and productive mechanism of coordination and collaboration that results in synergistic action for public good. In summary, One Health means working together of human, animal, and environment sectors to achieve shared objectives. This year’s World Rabies Day theme builds on the 2022 success of One Health, taking it a step further to focus more on collaboration, equality, and strengthening of health systems. There is a need for the global community to overcome unbalanced health systems and strife to achieve our global goal of Zero by 30. Meaning of each part of theme:
- All for One: The “All for One Health” aspect of this approach emphasizes the collective responsibility and collaboration required from various stakeholders to tackle rabies comprehensively. It encompasses governments, healthcare providers, veterinarians, wildlife experts, and local communities working together to achieve common goals.
- Number 1 can refer to a single person making a difference, to a community, to our one goal, to how one vaccinated animal protects all and how a single course of PEP can save a life.
- One Health for All: “One Health for All” embodies the idea that the benefits of a unified approach to rabies control should extend equitably to all individuals, regardless of their geographic location, socioeconomic status, or access to resources. This concept calls for global inclusivity and accessibility.
The theme addresses key trends within the rabies community, including collaboration seen through the united against rabies actions to operationalize One Health – improving human, animal, and environmental health as the three are inextricably link global trends, with the launch of the Pandemic Prevention Fund from the World Bank and the strong need to strengthen overall health systems. This can be achieved by building capacity through rabies control and elimination efforts and laying the foundation for other disease. One Health is a core concept and is mentioned considering the following:
1) That rabies elimination is a model for One Health collaboration.
2) The development of National Strategic Plans for rabies elimination.
3) International collaboration includes partners from all sectors.
This year’s theme brings together all key elements of rabies prevention, highlighting the need for cocktail approaches. we cannot eliminate rabies through just vaccinating dogs or just collecting data. We cannot eliminate rabies through education alone or only PEP access. Each situation needs its own tailored approach to educate the public, vaccinate dogs, monitor cases and work with all relevant authorities. Purposefully created a theme with a positive message by highlighting and reminding the global community that rabies elimination goal (Zero by 30) and that we stand united against this dreadful disease.
All for 1 – One Health for all
The Rabies control programmes offer a great example to operationalize One Health – building the structure and trust that other zoonotic diseases, including those that are pandemic-prone. Ensuring equitable access to health services and rabies post-exposure prophylaxis for underserved communities not only in national health systems.
Global Strategic Plan for the elimination of dog-mediated human rabies deaths by 2030. The world has the vaccines, medicines, tools, and technologies to break the cycle of one of the oldest diseases together in leaving no one behind.
The theme further emphasizes the importance of equality, and strengthening overall health systems by ensuring that One Health something that should be available to everyone.
Rabies elimination exemplifies the One Health approach, with participation and collaboration from human, animal, and environment commonly used as an example of operationalizing One Health. The spirit behind this theme encourages collaboration, partnership, and a joint efforts or “Zero Deaths”, in line with the “Zero by 30.
CHALLENGES AND SOLUTIONS:
Limited resources: One health acknowledges resource constraints and promote efficient allocation of funds and expertise.
Cultural beliefs: Addressing cultural practices that contributes to rabies transmission through community engagement and education.
Wildlife reservoirs: Understanding and managing the role of wildlife in rabies transmission through ecological research and conservation efforts.
CONCLUSION
Rabies remains a serious public health concern, but with a One Health approach, we have the potential to eliminate human deaths from this preventable disease. Collaboration between human and animal health sectors, alongside environmental awareness, surveillance, and research, can lead us toward the goal of zero rabies deaths. It is imperative that governments, organizations, and communities worldwide unite in the fight against rabies to protect both human and animal lives.
