After an international meeting of researchers, the World Health Organization is calling for renewed efforts in fighting a disease that kills one person every 10 minutes worldwide. The disease, which condemns tens of thousands of victims every year to a slow, painful death, is actually completely vaccine-preventable: rabies.
"About 59,000 people die per year of probably the most preventable disease on the planet, which is rabies," said Douglas Call, an epidemiologist at Washington State University. "If we can't stop rabies, weren't not going to be able to stop much of anything."
During a conference this week, the WHO rallied researchers and NGOs to renew efforts in battling the disease, which is almost always fatal and causes victims to suffer cerebral dysfunction and delirium as they die.
More than 95 percent of rabies deaths occur in Africa and Asia, with 99 percent caused by dog bites, which is why the WHO and other groups want to focus efforts on vaccinating dogs. If 70 percent of a dog population in a community is vaccinated, that provides a high enough herd immunity to prevent human infection, according to multiple studies.
A dog rabies vaccine costs about $1 US on average, so it seems like a simple task to start mass-vaccinating dog populations around the globe. But there are a number of challenges to achieving this goal.
"The biggest thing is cost," Call explained. "If a Maasai farmer has a choice between treating a cow or vaccinating a dog, they're going to put their money on their cattle because that's their whole equity. There are incredibly impoverished communities [affected by rabies] and so it's just not going to happen unless you provide incentives and free access."
Another challenge is the way some cultures treat dogs. Dogs aren't furbabies sleeping at the foot of the bed, they're working animals that are often free-range, leaving them susceptible to not only picking up disease but also to spreading it around. Dogs also have a shorter life expectancy on average in many parts of the world and spaying and neutering is less common, leading to a high turnover rate.
But there are strategies that researchers are investigating to overcome these obstacles. Providing communities with information about the importance of having dogs vaccinated as well as giving them free access to treatment and a small incentive—like a free dog collar—has proven effective at boosting vaccination rates, according to a study publishedearlier this month in PLOS Neglected Tropical Diseases.
The WHO is also calling for improved access to anti-rabies prophylaxis, the rabies shot you get after you've been bit to prevent rabies, which is often unavailable in rural parts of Africa and Asia. It's not an easy task—someone has to foot the bill for all these free rabies shots, for one—but there have been successful programs like this in the past. One WHO-backed project in the Philippines decreased the number of human rabies deaths by 34 percent in one year through mass dog vaccination.
"Who pays for it? Who pays for a lot of things? My guess is it would need to be a combination of NGOs, cooperatives, and local governments," Call told me, but stressed that there's no good reason why the disease persists at such a high level around the globe.
"Over 1,000 people a year die in Tanzania alone from this dreadful disease," Call said. "It's the worst way to go."