Human rabies: prospects for elimination

Area of Science:

• Veterinary Public Health
• Infectious Disease Epidemiology
• Global Health Security

Background:

• Dog-mediated rabies remains a significant threat, particularly in low- and middle-income countries, disproportionately affecting rural populations and children.
• Significant progress has been made in regional rabies elimination, notably in Latin America over the past 35 years.
• Sustained investment in dog vaccination, post-exposure prophylaxis, and robust surveillance systems are key drivers of successful rabies control.

Purpose of the Study:

• To assess progress toward the global elimination of human rabies deaths by 2030, using the 2017 Global Strategic Plan as a framework.
• To identify characteristics of successful regional rabies control efforts.
• To examine the barriers hindering rabies elimination in endemic countries.

Main Methods:

• Review of progress towards the 2030 Global Strategic Plan for rabies elimination.
• Analysis of successful regional rabies control strategies and their contributing factors.
• Identification and characterization of barriers to rabies elimination in countries with endemic disease.

Main Results:

• Nearly half of all countries have eliminated human deaths from dog-mediated rabies.
• Successful regional elimination is linked to sustained investment in dog vaccination, post-exposure prophylaxis, and surveillance.
• Significant barriers persist in countries where rabies remains endemic, hindering complete elimination.

Conclusions:

• Despite existing challenges, advances in knowledge, technology, institutional support, and economic factors provide a foundation for optimism in achieving global rabies elimination.
• Continued and strategic investment in proven control measures is crucial for overcoming barriers in endemic regions.
• The goal of ending human rabies deaths by 2030 is achievable with concerted global effort and tailored strategies for diverse country contexts.