Rabies is a vaccine-preventable disease that causes tens of thousands of deaths yearly. Although present in over 150 different countries, rabies is most common in developing countries, with 95% of cases occurring in Asia and Africa. Canines cause 99% of rabies infections, accounting for 40% of human rabies infections in Asia and Africa among children aged 15 and under.

Rabies Vulnerability in Developing Countries

Rabies is an extremely dangerous disease with a 99% fatality rate. Vaccination of animals and humans with high exposure rates is possible, but once infected there is little to stop the infection other than immediate treatment of multiple fast-acting shots and vaccines to help fight off the virus are administered with continuous wound washing.

The issue is that many people who live in poverty lack immediate access to these treatments and vaccinations. Even if these treatments are available, they come at a hefty price. Rabies post-exposure prophylaxis (PEP) costs an estimated $108 per treatment not including travel and shipping costs, according to the World Health Organization (WHO). Not only is treatment expensive and often unavailable, but developing countries also have limited diagnostic facilities and almost no rabies surveillance, according to the Centers for Disease Control (CDC).

The vaccination of stray dogs would greatly prevent the infection of humans, but this also comes with a steep cost and risks burdening public health resources even in the most stable countries. Globally, the burden of rabies costs around $120 billion.

Ethiopia Takes Action

Ethiopia is one of the most affected countries when it comes to rabies with an estimated death rate by rabies of about 2,700 deaths yearly. Ethiopia’s canine vaccination rate is far behind the 70% rate necessary to control the disease. Ethiopia suffers from the same limitations as other developing countries regarding inaccessible vaccinations and PEP treatments. As of 2019, 68.7% of Ethiopia’s population is multidimensionally poor.

Despite Ethiopia’s challenges, it still implemented many programs to fight against rabies infections that plague the country due to its high poverty rates and increased vulnerability. Rabies experts from the CDC have been working closely with Ethiopian leaders to determine the best way to safely take on the issue. Local animal surveillance officers and veterinarians get training on the capturing, vaccinating and releasing of stray dogs to control the source of infectors safely and effectively.

Public awareness and methods of youth education are also being implemented to protect young people from becoming infected due to canine exposure. The University of Mekelle has been providing awareness sessions to more than 7,000 children in schools across Ethiopia. However, a large portion of Ethiopian children is still at great risk due to high levels of multidimensional poverty which leads to a large number of children who do not attend formal school programs. With programs that target a larger community-based audience, more people could benefit from education and interest in participating in safe response protocols such as immediate wound washing and PEP administration.

Vaccination centers located in precise locations based on the high canine population have been recommended by the CDC and are expected to bring about positive coverage results. These are all necessary steps in the control of rabies in developing countries.

Looking Ahead

Ethiopia is setting the standard for the control of rabies in developing countries. With the improvement of educational sources, health services and animal control services rabies contraction in humans could be under control. However, as long as multidimensional poverty persists it is unlikely that rabies and other neglected diseases will be able to decrease.

– Leah Smith
Photo: Flickr