Katie Hampson - World Organisation for Animal Health · Rabies deaths/ 100,000 Every year: 59,000...
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Transcript of Katie Hampson - World Organisation for Animal Health · Rabies deaths/ 100,000 Every year: 59,000...
Katie Hampson University of Glasgow
The Impacts of Rabies and Benefits of Prevention
Maison de la Paix - Geneva, Switzerland - 10 – 11 December 2015
Glasgow: S Cleaveland, D Haydon, T Lembo, R Mancy, S Townsend, I Rysava Tanzania: Ifakara Health Institute, Sokoine University of Agriculture
Indonesia AAG Putra, FAO: E Brum, L Schoonman, BAWA: J Giradi, GN Bagus Americas: PAHO - V Del Rio Vilas, M Carvalho, M Vigilato,
MEX V Guitierrez Cedillo & co, BRA E Pacheco de Caldas, S Rocha & co. Partners for Rabies Prevention, GARC, Louise Taylor
Wellcome Trust, Medical Research Council, Bill & Melinda Gates Foundation UBS Optimus Foundation
Every year: 59,000 deaths, 3.7 million DALYs, $8.6 billion
Official records severely underestimate the burden of rabies
Rabies
deaths/
100,000
Every year: 59,000 deaths, 3.7 million DALYs, $8.6 billion
$$ on dog
vaccination/
100,000
Per capita death rates are highest in the poorest countries
Burden reflects lack of investment in dog vaccination
$0.01 $0.014 $0.114 dog vax dog vax dog vax
Africa Asia Latin America
Rabies deaths per million population 20.9 9.3 0.34
Per Capita Expenditure
$0.15 $0.34 $0.24 PEP PEP PEP
Africa Asia Latin America
Rabies deaths per million population 20.9 9.3 0.34
Per Capita Expenditure
Africa Asia Latin America
Rabies deaths per million population 20.9 9.3 0.34
Dog Vaccination 6% 15% 60% Coverage
Dog vaccination is a cost-effective approach to human rabies prevention
From Endemic to Eliminated
Low income High income Highest death rate
Least $ per capita on dog vax
Lowest death rate Most $ per capita on dog vax
Pre-control Control Elimination Freedom
From Endemic to Eliminated Pre-control Control Elimination Freedom
Poorest countries: • Investing in dog vaccination saves lives of those with poor access to health
services
Incremental Cost-effectiveness Ratio of dog vaccination: $300/ life year saved! ($2000 = WHO very cost effective!) Fitzpatrick et al. 2014
• Wildlife are not an obstacle
• Vast majority of dogs are owned
• Almost all dogs accessible for vaccination
MASS DOG VACCINATION NEEDS TO
START!
From Endemic to Eliminated Pre-control Control Elimination Freedom
Poorest countries: • Investing in dog vaccination saves lives of those with poor access to health
services
Low-middle income countries: • Investing in dog vaccination can enable countries to rapidly approach
elimination & save expenditure on PEP
Each year saving >100 lives & $1.5 million on Bali
Annual dog vaccination on Bali, Indonesia has reduced rabies to very low incidence
Mass vaccinations have eliminated rabies locally from
several areas of the Philippines
From Endemic to Eliminated Pre-control Control Elimination Freedom
Countries approaching elimination: • Investing in neighbouring/ problem areas will result in
disease freedom & massive long-term savings
Poorest countries: • Investing in dog vaccination saves lives of those with poor access to health
services
Low-middle income countries: • Investing in dog vaccination can enable countries to rapidly approach
elimination & save expenditure on PEP
• >99% reductions in cases (speed varied by areas, population & wealth!) • Coordination synchronized dynamics facilitating elimination
LATIN AMERICA & CARIBBEAN
Focus on improving vaccination in poorest/ problematic areas
Mexico
Brazil
Bolivia Columbia
• >99% reductions in cases (speed varied by areas, population & wealth!) • Coordination synchronized dynamics facilitating elimination
LATIN AMERICA & CARIBBEAN
Focus on improving vaccination in poorest/ problematic areas
Mexico
Brazil
Bolivia Columbia
CONCLUSIONS
Poorest countries: • Investing in dog vaccination saves lives of those with poor
access to health services Low-middle income countries:
• Investing in dog vaccination can enable countries to rapidly approach elimination & save expenditure on PEP
Countries approaching elimination: • Investing in neighbouring/ problem areas will result in disease
freedom & massive long-term savings
By working together, engaging communities and committing to sustain dog vaccinations,
rabies can be eliminated
Bites
$$
DALYs
deaths
Healthy
PEP No PEP
Alive Rabies
Rabid
No PEP PEP
Vaccination coverage
Dogs
HDI
DALYs
$$ Regimens, vaccines,
RIG
rabid dog bite
receive PEP
develop rabies
Livestock $$
Population Control
$$
Surveillance
DATA: Questionnaires, literature, cluster extrapolation OUTPUTS
