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Vaccine Alliance steps up bid to end rabies by 2030 after Covid-19 pause

The UN’s Gavi, the Vaccine Alliance, has restored its efforts to prevent and control rabies globally by increasing the availability of vaccines and eliminating the disease by 2030 after Covid-19 disrupted its rollout.

HQ Team

June 16, 2024: The UN’s Gavi, the Vaccine Alliance, has restored its efforts to prevent and control rabies globally by increasing the availability of vaccines and eliminating the disease by 2030 after Covid-19 disrupted its rollout.

The alliance had initially agreed to include human rabies vaccines for post-exposure prophylaxis in its 2021-25 Vaccine Investment Strategy. However, the COVID-19 pandemic delayed the program until mid-2023, when the Gavi board decided to restart.

“Eligible countries are receiving guidance on how to access these vaccines under Gavi’s co-financing policy. The first round of applications will be accepted by mid-July 2024. Ninety-five percent of human rabies deaths occur in Africa and Asia, most often in marginalised communities that lack access to care,” according to a WHO statement.

The word “prophylaxis” means to prevent or control the spread of an infection or disease. It should be used only in emergencies.

Rabies is a viral disease that causes severe inflammation of the brain. In 99% of cases, it is transmitted to humans by a rabid dog. Once the virus reaches the central nervous system and an infected person shows clinical symptoms, rabies infection is nearly 100% fatal.

Most feared disease

The deadly nature of rabies and its traumatic symptoms make it one of the world’s most feared diseases. However, rabies infection is preventable by prompt post-exposure prophylaxis, which consists of thorough wound washing, administration of a course of quality human rabies vaccine, and immunoglobulins if needed.

The new restart programme complemented ongoing global efforts of the Zero by 30 campaign, led by United Against Rabies partners including the Food and Agriculture Organization (FAO),  the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH, formerly OIE) to eliminate dog-mediated human rabies by 2030.

“This commitment from Gavi is crucial and will expedite efforts to halt human fatalities caused by dog-mediated rabies,” said Dr Jerome Salomon, assistant director-general for Universal Health Coverage, Communicable and Non-Communicable Diseases at the WHO.

“WHO will provide technical assistance to countries, not only to support their funding applications to Gavi but to draw up comprehensive plans of action that can deliver real progress towards the Zero by 30 goals,” he said.

In more than 150 countries where dog rabies remains a serious public health problem, stocks of human rabies vaccines in public health systems are often extremely limited, especially in marginalised communities, according to the WHO statement.

Dog vaccines not covered

“Where human rabies vaccine is available through private facilities, the cost of post-exposure prophylaxis can impose a catastrophic financial burden on families and communities.”

All Gavi-eligible countries can apply for support to invest in human rabies vaccines for post-exposure prophylaxis.

Funding will be available for vaccine procurement and associated supplies. Rabies immunoglobulins and dog vaccines are not covered by this program. 

Countries are not required to have a national rabies control plan in place to apply for the first round of multiyear funding, but a national plan will be mandatory for all subsequent applications.

Funding applications will be accepted by Gavi in 2024 by 15 July and by 23 September 2024, with subsequent funding windows open three times every year.

“Gavi’s investment is hugely important and underpins a key pillar of the global strategy to stop people dying from this terrible disease,” said Prof Lucille Blumberg, chair of United Against Rabies.

“But to stop human rabies deaths completely, we urgently need better data and surveillance, dog populations must be vaccinated, and people must be educated about what to do if bitten, and how to avoid being bitten in the first place. 

“Stopping human deaths from rabies is within our reach, but it will take multiple sectors working together to achieve it,” she said.

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