Rabies Research & Impact Katie.Hampson@glasgow.ac.uk Tiziana.Lembo@glasgow.ac.uk Sarah.Cleaveland@glasgow.ac.uk Daniel.Haydon@glasgow.ac.uk Jim.Caryl@glasgow.ac.uk Dog vaccination Surveillance Community engagement Health inequalities & access Health systems Disease Burden Large-scale Interventions Socioeconomic Impacts Field epidemiology Disease ecology Transmission Evaluating Impacts Modelling control & elimination Strategy & Policy design Cost-effectiveness Molecular epidemiology
Case 1: Endemic rabies in sub- Saharan Africa, focus in Tanzania Context Pre control Control stage Elimination stage Maintenance stage Rabies Epidemic in rabies free area Case 2: Epidemic in Bali, Indonesia Persistent foci. Risk of re emergence if control measures lapse Rabies no longer detected Rabies may still be circulating undetected. Risk of re emergence if control measures lapse Incursion may cause outbreak. Risk of re emergence if control measures lapse Certified free AFRICA >30,000 deaths $0.75 billion losses $0.01pc on dog vaccination ASIA ~30,000 deaths $4 billion losses $0.03pc on dog vaccination AMERICAS <200 deaths $0.3 billion losses $0.13pc on dog vaccination
Case study 1. Building the evidence: The burden of rabies is substantial Elimination of rabies through dog vaccination is epidemiologically & operationally feasible & affordable
Case study 1. Knowledge transfer Knowledge exchange was (mostly) our pathway to impact A range of stakeholders: High-level policy making bodies (international organisations, global NGOs) Regional networks Governmental bodies Professional associations (central / local level) Communities Activities: meetings / workshops, professional training, development & delivery of materials, infrastructure
Meetings / workshops
Training of field personnel
Training of laboratory personnel
Reports, briefings & tools for national governments & international organisations
Evidence collection (testimonials, use of findings by others) were instrumental in the development and design of the project for human and dog rabies elimination in developing countries successfully submitted by the WHO.. to the Gates Foundation Director of NTDs, WHO Our teams have benefited greatly from the information and guidance in the Canine Rabies Blueprint GARC Asia Coordinator This initiative (National Strategy for Rabies Elimination & Control in Kenya) was stimulated.by the University of Glasgow MoH & MoALDF, Kenya
Case study 2 Research on request Stakeholder identification & Engagement Partners mediated: Consultations that influenced research e.g. exploring culling, modeling strategies The influence of research on practice Consultation led to collaboration
Case study 2 Research on request 2013
Case study 2 Research on request 2013 Island-wide campaigns essential for elimination: saving 500+ lives & $15m over 10 yrs
Empowering stakeholders to turn knowledge into long-term action Starting from the perspective of the people we are trying to reach and involving them in the solution: WHO needs to know / be involved? What is their EXISTING KNOWLEDGE HOW CAN THEY CHANGE: What do they need to know? MESSAGES / MATERIALS tailored to end-users Understanding their MOTIVATION: Personal, economic, social, political BARRIERS INVOLVEMENT: How can they become involved in the solution? COLLABORATION: Who can help reach them? ACTION AND SUSTAINABILITY: How do we know it will be put into action and sustained?
Reports & briefings for NGOs, local & national governments & international organisations
Evidence collection (testimonials, use of findings by others) I believe we succeeded to run our program on budget and on time because we had Glasgow s experts to back us up. It gave us the courage to continue with out plan even under extreme stress Director BAWA
How to do this better - next steps We had no strategy for achieving impact (no guidelines) Our science focus on controlling rabies is impactful (Conscious Competence) Evaluation critical to demonstrating impact: Bank information / repositories of evidence corroborate impact Ways of better assessing impacts on health / quality of life / understanding / behaviour?
How to do this better community engagement
Take-home Key research outputs were only a small component Collect REF-centric evidence to corroborate impact Research that is stakeholder-led/ influenced is easier to make impactful (at least in shortterm for REF)