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Lack of reliable data hinders efforts to reduce rabies in dogs and humans
View(s):By Nathara Abeywickrema
Sri Lanka aims for zero rabies by 2025, but requires more effective, evidence-based strategies for its elimination.
The estimated dog population in Sri Lanka is 2.1 million, and the annual canine vaccination coverage has ranged from 34% to 56%. Rural and suburban areas have a high proportion of free-roaming dogs with unrestricted access to wild animal habitats.
Sri Lanka is the only country that gives anti-rabies medicines for free.
Public Health and Veterinary Services Director Dr. Dharshani Dissanayake said the prevalence of dog rabies is higher. There are currently reports of feline rabies as well.
Human rabies deaths were reduced to 16 last year.
A framework is proposed to assess the value of rabies interventions holistically. The Health Ministry has been presented with guidelines in this regard for approval over the development of a novel approach to sustain high coverage based on decentralised and continuous delivery of vaccinations, Dr. Dissanayake said.
For two more months, there are enough anti-rabies dog immunisations. There is a shortage of rabies vaccines in the hospitals in the periphery, but the regional directors of health services (RDHS) are balancing the stocks that are available at MOH (medical officers of health) levels.
Dr. Dissanayake said that by next month, one million vaccines will be imported to vaccinate dogs.
There is no lack of immunisations for people admitted to hospitals, but if rabies spreads among canines, this might quickly change.
Private veterinarians under contract with the Health Ministry perform surgical sterilisation and birth control procedures on roaming, ownerless dogs.
These initiatives were anticipated to decrease the dog population over the past 10 years, which would in turn lower the number of dog bites and rabies cases. The data that is currently available, however, indicates that the number of dog bite occurrences, dog rabies cases, or the dog population has decreased.
In addition, not all hospitals record or submit information on dog bites among humans in a bite registry, nor is it consistently done.
While Sri Lanka is making strides in the direction of eradicating human rabies, companion animal rabies remains an issue across the country.
The main goal of animal rabies control is to prevent rabies in dogs, which calls for controlling the population growth of dogs that wander freely without owners as well as coordinated, ongoing vaccination programmes.
To eradicate canine rabies, vaccination campaigns must be swift and equitable throughout large geographic areas and be expanded to a sizeable portion of the populace.
Because the necessary tasks do not fit into a single domain under one administrative department, rabies control and ultimate elimination require a multidisciplinary and collaborative strategy based on the One Health paradigm.
It is imperative to build a rabies surveillance system for domestic and wild animals, supported by a network of rabies diagnostic laboratories widely dispersed geographically.
The Health Ministry needs to raise public awareness of ways to avoid dog bites and the possibility that domestic animals like dogs could be infected with rabies from wildlife.
All hospitals should have post-exposure prophylaxis (PEP) available, and it is crucial to stress the need to get medical attention if exposed.
Dr. Chamith Nanayakara, the founder of the Association of Veterinarians for Humane Management of Animal Populations, said effective coordination and the development of a combined model are required from the Health Ministry and other animal welfare organisations.
Legal authority must be granted to local government organisations for the registration and immunisation of all dog breeds as well as the capture, holding, and eventual release of roaming, unclaimed ownerless dogs to suitable facilities, Dr. Nanayakkara noted.
Zero rabies-related deaths in humans are not achievable if canine rabies is not under control. Achieving immunisation in at least 70% of dogs—that is, all three groups of owned and confined, semi-owned free-roaming, and ownerless free-roaming dogs—is a crucial prerequisite for ending the cycle of rabies transmission.
The absence of trustworthy data on the size, distribution, and ecology of the dog population in Sri Lanka is a significant obstacle to reaching this goal, said the president of the Sri Lanka Veterinary Association, Dr. Mohamed Ijaz.
Surveys are needed to estimate the overall number of dogs, the relative proportions of dog types, and their habitats: urban, suburban, rural, etc.
The secretary of the Kandy Association for Community Protection through Animal Welfare (KACPAW), Champa Fernando, noted that since the Department of Animal Production and Health (DAPH) was replaced by the Ministry of Health, rabies control programs have not improved.
With the assistance of private veterinarians and DAPH veterinarians, the Health Ministry must aim for 70% vaccine coverage of the total canine population. Additionally, birth control programmes must be expanded.
Community help is needed for a successful rabies control programme and to manage the dog population.
Ms. Fernando said the proposed animal welfare bill includes fines for those who abandon their pets.
Laws about dog ownership, registration, and immunisation must be updated and strictly enforced, and responsible dog ownership must be promoted through public awareness campaigns and education, Ms. Fernando said.
The municipal councils of Kandy and Nuwara Eliya, along with private animal welfare organisations, have helped to reduce the number of street dogs by promoting dog sterilisation.
She said that Rs. 200 million is being spent annually to sterilise dogs.
“It is high time the DAPH took over management of the entire rabies control programme to ensure seamless operations,” Ms. Fernando said.
Dr. Sisira Piyasiri, president of the State Veterinary Surgeons’ Association, noted that only the Health Ministry oversees rabies control initiatives.
The ministry has taken over the 2008 rabies control programme from the DAPH due to its lack of progress since 2018.
“Implementing rigorous programmes is the responsibility of community physicians and education officers at the regional director of health services office,” Dr. Piyasiri said.
No veterinarian is overseeing the national dog immunisation programme. The programme coordinators are ignorant of the vaccination process and storage conditions, and they frequently attempt to give dogs other vaccinations in addition to the anti-rabies shot, which would have weakened the animal’s immunity, Dr. Piyasiri said.
He called for greater vaccination coverage and animal birth control. It is vital to guarantee sufficient human and material resources for this.
Upul Rohana, president of the Public Health Inspectors’ Union, said that the lack of staff was the reason why national dog sterilisation campaigns are undertaken sporadically.
Dr. Amila Gunesekere, the medical officer in charge of the National Hospital’s Anti-Rabies Unit, suggested vaccinating the dog.
Referring to the delayed animal welfare bill, lawyer Lalani Perera, a strong animal welfare advocate, said: “It is very unfortunate that the bill, which was finalised after wide consultation and is now on the Parliamentary Order Paper (which is a public document), did not face any objections for nearly one and a half years, but is now being delayed due to some criticism.
“The Bill, languishing in Parliament without enactment, means that the non-humans and the voiceless will continue to suffer horrendous cruelty with no meaningful recourse to legal protection.’’
Providing facilities for government and private veterinary doctors to vaccinate dogs, employing dog catchers to capture and transport animals for vaccination, and using oral bait vaccinations are some of the ways with which to cover all breeds of dogs. Also, a reliable and long-lasting system for identifying vaccinated canines is needed.
If all stakeholders address the problems and constraints and work toward a collaborative national action plan based on the One Health model, zero rabies can be achieved by 2030.
Sri Lanka needs more effective, evidence-based strategies to eliminate rabies. Human rabies deaths have declined from 377 in the mid-1970s to 2021 as a result of vaccinations.
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