The Importance of a One Health approach in controlling rabies

Rabies is linked to more than 55,000 human deaths every year. Human transmission vectors vary around the world with low- and middle-income countries most severely affected. This review focuses on the situation in Nepal and highlights the importance of a One Health approach to effectively control this lethal disease worldwide.

In Nepal, rabies is endemic and moderately prevalent. Most cases are linked to dog bites with only 4% caused by interactions with other animals. Mass vaccination campaigns and dog and cat population management programs have been in place since the early 2000s, together with post-exposure prophylaxis and awareness programs, yet cases have not reduced as expected. Despite this, Nepal is still aiming to end human deaths from rabies by 2030.

A possible explanation for the failure to reduce cases has been a lack of communication between stakeholders (human, animal, and environmental health sectors). So, since January 2020, Nepal has been implementing a One Health approach in all relevant sectors, including zoonoses and antimicrobial resistance. This strategy has already shown positive outcomes in countries, including Bhutan, Bangladesh and Sri Lanka. As part of the new approach, it adopted the following measures:
• Systematic data collection and compilation
• Co-ordinating and data sharing among animal, human and environmental health sectors
• Efficient and effective surveillance
• Ensuring the sufficiency and availability of post exposure prophylaxis (PEP)
• Increasing vaccine coverage
• Increasing the efficacy of vaccination
• Raising awareness
• Strengthening laboratory capacity
• Carrying out research

This paper summarizes the approach taken in Nepal. It confirms that a multi-sectoral One Health approach is the most effective strategy to control rabies in countries where it is endemic. Veterinarians, of course, have a fundamental role to play in this.

K.P. Acharya, N. Acharya, S. Phuyal, et al. One-health approach: A best possible way to control rabies. One Health (2020). https://doi.org/10.1016/j.onehlt.2020.100161