To effectively eliminate rabies in the continent, there is need for the right information on its prevalence, transmission patterns, vaccination rates and treatment efficacy. Credit: Shutterstock
By Isatou Touray
Nov 28 2024 – Rabies, despite being a major public health concern in Africa, is still not fully understood, due to the limited data available on it. This has slowed down efforts to eliminate it, yet the continent bears a significant burden of the disease and accounts for most of the deaths it causes globally.
With the exception of only a handful of countries, the continent generally has poor and incomplete data on this disease that results from bites or scratches by an infected dog. According to the World Health Organisation (WHO), the disease is responsible for an estimated 59,000 deaths in the world every year, out of which 95 per cent are in Africa and Asia.
All this arsenal against the disease has largely been rendered ineffective by the absence of complete, reliable, high-quality data that could inform effective decision making and proper management. Without the full picture that only data can paint, decision makers cannot see the true scale and impact of the disease is unclear
Even in cases that are not fatal, rabies, like other Neglected Tropical Diseases (NTDs) – a group of 20 diseases that debilitate, disfigure and can kill – robs individuals of good health, dignity and livelihood.
Rabies, in particular, causes progressive and potentially fatal inflammation of the brain and spinal cord that make up the central nervous system. It often leads to death once the virus infects the central nervous system and the symptoms appear, underlining the urgent need for prompt treatment.
The good news is that the knowledge and tools for tackling rabies, which is one of the oldest human diseases, are well known, proven and available. Vaccines and antibodies that can save lives in case of infection exist, as well as dog vaccines to keep the virus at bay.
The bad news, however, is that all this arsenal against the disease has largely been rendered ineffective by the absence of complete, reliable, high-quality data that could inform effective decision making and proper management. Without the full picture that only data can paint, decision makers cannot see the true scale and impact of the disease is unclear.
To effectively eliminate rabies in the continent, there is need for the right information on its prevalence, transmission patterns, vaccination rates and treatment efficacy. Armed with this, it becomes easier to identify infection hotspots, monitor and evaluate interventions and deploy equitable responses.
Better appreciation of the disease will help trigger action by governments, funders and other actors in securing resources and mobilising action to relieve needless suffering and decrease health-related drivers of poverty.
Ultimately, this will help the continent inch towards attaining Sustainable Development Goal 3.3 that targets a 90 per cent reduction in the number of people who need NTD intervention.
Over the last decade progress has been made against NTDs, leading to 600 million fewer people requiring NTD intervention between 2010 and 2020, which has been attributed to strengthening domestic and international commitment.
There is a greater opportunity to accelerate this progress further by focusing the fight against rabies. Without this crucial data, efforts against the disease will remain piecemeal, reactive, unfocused and inefficient.
This will leave individuals suffering and could sometimes lead to preventable deaths. The WHO estimates the global cost of rabies to be about US$8.6 billion annually, arising from lost lives and livelihoods, medical care and associated costs, as well as uncalculated psychological trauma.
Absence of proper data also makes it more difficult to mobilise national and international resources for control, elimination and eradication of the disease.
Significant and sustainable resources are required to avail vaccines to at high-risk individuals and emergency treatment to communities that cannot afford them. Also critical in the fight is mass vaccination of dogs that has been found to be effective in controlling rabies, as well as public awareness and education campaigns on preventing bites and what to do when bitten or scratched.
All this begins with quality data and robust data systems. This is the compass in the fight against rabies and other NTDs in Africa. It is also a guide for elimination of the disease by identifying where to deploy vaccines, provide treatment and rollout requisite infrastructure.
It is worth highlighting that Kikundi, a community of practice for NTD Program Managers in Africa, is well positioned to strengthen the efforts to enhance data quality and build robust systems, ultimately supporting countries in their fight against rabies.
As highlighted in the theme of this year’s World Rabies Day – ‘Breaking rabies boundaries’, it is time to disrupt the status quo by improving our understanding of this disease. No one in Africa should continue suffering and dying from preventable and treatable diseases like rabies.
Dr Isatou Touray, a former Vice-President of the Republic of the Gambia, is the interim Executive Director of Uniting to Combat Neglected Tropical Diseases.