Inception meeting of the OIE/JTF Project for Controlling Zoonoses in Asia under the One Health Concept OIE global strategy for rabies control, including regional vaccine banks Tokyo, Japan 19-20 December 2013 Dr A. Dehove Coordinator of the OIE World Animal Health and Welfare Fund
OIE global strategy for rabies control 2
3 OIE global strategy for rabies control The Global Conference on Rabies Control: Towards sustainable prevention at the source in Incheon-Seoul (Rep. of Korea) on 7-9 Sept. 2011 in collaboration with FAO and WHO Adoption of recommendations on a global strategy for controlling rabies in dogs worldwide
4 OIE global strategy for rabies control Dog vaccination is the most cost-effective single intervention to protect humans from contracting rabies. Dogs are the main source and major reservoirs of rabies in most infected developing and emerging countries. Controlling rabies in owned dogs and stray dog populations when possible is key to preventing human deaths by rabies worldwide.
5 OIE global strategy for rabies control In too many countries, dog vaccination is not yet considered as the key solution to eliminate rabies in humans. (Global) Communication is required to disseminate the need to realign priorities and make dog vaccination a key public health action for public health authorities / local authorities. (National) public funds are mainly allocated to Post Exposure Prophylaxis (vs. dog vaccination).
6 OIE global strategy for rabies control Historic lack of involvement of national Veterinary Services (vaccination of stray / semi-owned dogs) Lack of clear national policies, lack of public/private partnerships and coordination at global / regional / national / local (municipalities, communities) levels
7 OIE global strategy for rabies control The systemic vaccination of animals (dogs), if carefully planned, involving relevant experts and stakeholders, reduces over time the high cost of post-exposure treatment/prophylaxis in humans currently applied with high cost to hundreds of thousands of people worldwide. To start and sustain a successful rabies control programme, the following institutional challenges should be considered:
8 OIE global strategy for rabies control a) sustainable control of rabies relies on formally establishing an exchange of information and collaborative mechanism between all sectors involved; b) public health impact of rabies calls for budgetary allocations across several government ministries, which is usually difficult to negotiate or coordinate;
9 OIE global strategy for rabies control c) campaigns for rabies eradication have to be implemented thoroughly over several years in order to be successful; d) significant variations from region to region or even within countries as to which institution takes the lead in implementing a rabies control programme - there is no model that fits every situation; and e) most resource-limited countries expect their veterinary services to give priority to the health of livestock, which excludes dogs.
10 OIE global strategy for rabies control Several important accompanying measures, as described by the OIE international standards, are also required: monitoring and control of the dog population; public awareness and education campaigns (for the general public, for dog owners and children); prevention of rabies (border control, monitoring and control of animal movements);
11 OIE global strategy for rabies control harmonisation of strategies and control measures between government ministries and neighbouring countries (particularly in the control of rabies in wild or feral animals); use of quality vaccines and diagnostic tests; pre- and post-vaccination monitoring target populations; surveillance and management of wildlife.
12 OIE global strategy for rabies control Large-scale animal depopulation (wild and domestic), alone, is not the generally recommended approach to control rabies; depopulation should always be combined with other control measures. The OIE encourages its Member Countries to include OIE listed diseases such as rabies in their national legislation as compulsory notifiable diseases so as to facilitate the notification of outbreaks (in domestic animals and wildlife).
13 OIE global strategy for rabies control The surveillance of rabies would be enhanced by laboratory diagnosis and subsequent reporting of confirmed cases of animal rabies, preferably through WAHIS, as well as by examining suspect (sick or dead) animals rapidly and systematically. As a zoonotic disease, human rabies will be reported in the annual report to OIE Member Countries.
14 OIE global strategy for rabies control OIE Reference Laboratories and WHO Collaborating Centres are working together to achieve an international harmonisation of laboratory methods for diagnosing rabies and conducting the quality control of vaccines.
15 OIE global strategy for rabies control OIE laboratory twinning projects 3 Lab. twinning projects on rabies have been successfully completed in Turkey, Nigeria and China (OIE RL since May 2012). Another laboratory in Rep. of Korea, was also selected as an OIE RL for rabies (May 2012). There is thus a total of 9 OIE Reference Laboratories for rabies, 5 of which are also WHO Collaborating Centres for rabies. In 2012, the OIE received at least 3 new twinning requests from different countries for rabies.
16 OIE International standards 1/4 OIE Terrestrial Animal Health Code chapter on rabies amended to take into account the change in lyssavirus taxonomy and addresses only classical types rabies caused by the rabies virus (formerly called as Rabies Virus Genotype-1). As an intermediate step towards being rabiesfree in all terrestrial mammalian species and to minimise public health risks due to canine rabies, the OIE has introduced provisions to control rabies in dogs in the Terrestrial Code Chapter 8.11.
17 OIE International standards 2/4 This step aims to improve transparency in reporting and increase the engagement of countries in rabies control programmes, especially in those which would not be able to reach the stage of being rabies-free regarding susceptible species in the short term.
18 OIE International standards 3/4 The quality standards for rabies diagnostic tests and vaccines (OIE Terrestrial Manual) have been updated to include the most recent evolution of scientific concepts. The production and use of both injectable and oral vaccines has been extensively revised. For injectable vaccines, the utilisation of live animals to test the potency of batches is discouraged and alternative tests have been included as an alternative.
19 OIE International standards 4/4 The new Terrestrial Manual has created a special chapter for the necessary tests for registration of rabies vaccines by Authorities as well as a chapter describing reduced control tests for commercial batch release following successful registration.
Rabies Vaccine Banks for dog vaccination 20
21 Rabies Vaccine Banks for dog vaccination Countries embarking on eliminating rabies in dogs require easy access to quality-assured dog vaccines for planned campaigns and outbreak management. Vaccinating at least 70% of dogs in endemic areas breaks the cycle of transmission in dogs and to humans, thereby preventing rabies in humans most efficiently.
22 Rabies Vaccine Banks for dog vaccination Vaccine banks can help to guarantee: Availability of high quality parenteral vaccine complying with international standards; Purchase cost reduction per vaccine unit; Rapid dispatch of emergency costs in line with field needs; Reduction of administrative delays and costs associated with local registration and the purchase of biologicals.
23 Rabies Vaccine Banks for dog vaccination Rabies Vaccine Banks can be used to facilitate high quality vaccine procurement and deliveries. The cost for the beneficiary should be adapted to the economic status of the country, taking into account that rabies control is a global public good.
24 OIE Regional Vaccine Banks 2010: EU funded Regional cooperation programme on highly pathogenic and emerging and re-emerging diseases (HPED) in Asia OIE Vaccine Banks expanded to other highly pathogenic emerging and re-emerging animal diseases, including FMD and Rabies Programme now extended to Dec. 2014
25 OIE Rabies Regional Vaccine Bank (Asia) One supplier provides parenteral (injectable) rabies vaccines for dogs in 10ml vials >3M doses could be made available (up to 8M) A second supplier provides parenteral (injectable) rabies vaccines for dogs in 1ml vials as well as oral vaccines for research projects in pilot countries. Eligibility Criteria endorsed by representatives of national Veterinary Services in Asia (Lijiang, PRC, March 2012).
26 OIE Rabies Regional Vaccine Bank (Asia) Injectable vaccines in 10ml vials available within 10 working days or up to 15 weeks depending on quantity ordered Production orders to date: Initial physical stock shifted from 50,000 to 400,000 doses + 500,000 doses ready for delivery early Feb. 2013 + 500,000 doses ready for delivery mid-feb;2013 + 500,000 doses ready for delivery early March 2013 + 500,000 doses ready for delivery mid-july 2013 + 500,000 doses ready for delivery early Sept. 2013
27 OIE Rabies Regional Vaccine Bank (Asia) Deliveries to date: Lao 50,000 doses, 2012 World Rabies Day Vietnam 200,000 doses, Dec. 2012 Philippines 500,000 doses, Feb. 2013 Lao 120,000 doses, June 2013 Sri Lanka 300,400 doses, June 2013 Bangladesh 200,000 doses, July 2013 Indonesia 200,000 doses, July 2013 Bhutan 20,000 doses, Sept. 2013 Myanmar 200,000 doses, 2013 World Rabies Day Nepal 200,000 doses, Oct. 2013 Vietnam 500,000 doses, Dec. 2013
28 OIE Rabies Regional Vaccine Bank (Asia) Total OIE deliveries to Asian countries to date: 2 490 400 doses of rabies vaccines for dog vaccination
29 Thank you for your attention Organisation Mondiale de la Santé Animale World Organisation for Animal Health Organización Mundial de Sanidad Animal 12 rue de Prony, 75017 Paris, France www.oie.int oie@oie.int