Rabies and rabies control in African regions

摘要

Despite the preventability of rabies, the disease has progressively expanded in dog and other carnivore populations of sub-Saharan Africa over recent decades. Although rabies is a notifiable disease in the majority of African countries, it is easily neglected as it often oscillates in a disconnected fashion between authorities concerned with either human or animal health. Given a disconcerting lack of epidemiological surveillance and inconsistent reporting to regional and global structures, the objective of eradication will always be difficult to justify on national agendas or to global funding agencies.On a continental level, the One Health approach has already been shown to be successful for dog rabies control in at least one part of the developing world, when implemented by the Pan American Health Organization in Latin America. In contrast, there isno pan-African approach to rabies control, although small regional efforts present hope. The rabies control programme in Kwa-Zulu Natal (KZN) in South Africa, supported by the Bill and Melinda Gates Foundation, celebrated a year free of human rabies on 24 June 2011. That occasion constituted the first time in 20 years that KZN has not recorded a single human death from rabies in a full calendar year. This is, however, a very small victory in the face of the continent-wide challenge. The authors suggestthat the road to an effective strategy for rabies control in Africa starts with a pan-African approach towards establishing sound surveillance and reporting structures. Clearly, only a sustained and reliable demonstration of the extent of the disease burden will allow a higher priority to be given to rabies on national and global agendas. The success of such a venture is certain to be conditional on the coordinated guidance and support of the World Organisation for Animal Health, the World Health Organization and other global partners in the 'One Health'model.