Busch, Frank

Dürr, Salome

Fahrion, Anna S.

Freuling, Conrad M.

Heitz-Tokpa, Kathrin

Léchenne, Monique

Mauti, Stephanie

Muturi, Mathew

Müller, Thomas

Recuenco, Sergio

Vigilato, Marco A. N.

English

Institutional Repository of the Freie Universität Berlin

TYPE EditorialPUBLISHED 18 July 2023DOI 10.3389/fvets.2023.1220327OPEN ACCESSEDITED AND REVIEWED BYSyed Shahid Abbas,Institute of Development Studies,United Kingdom*CORRESPONDENCEAnna S. Fahrionanna.fahrion@fli.deRECEIVED 10 May 2023ACCEPTED 07 July 2023PUBLISHED 18 July 2023CITATIONFahrion AS, Freuling CM, Léchenne M, Müller T,Recuenco S, Vigilato MAN, Busch F,Heitz-Tokpa K, Mauti S, Muturi M and Dürr S(2023) Editorial: Rabies, a long-standing OneHealth example – progress, challenges, lessonsand visions on the way to 0 by 30.Front. Vet. Sci. 10:1220327.doi: 10.3389/fvets.2023.1220327COPYRIGHT© 2023 Fahrion, Freuling, Léchenne, Müller,Recuenco, Vigilato, Busch, Heitz-Tokpa, Mauti,Muturi and Dürr. This is an open-access articledistributed under the terms of the CreativeCommons Attribution License (CC BY). The use,distribution or reproduction in other forums ispermitted, provided the original author(s) andthe copyright owner(s) are credited and thatthe original publication in this journal is cited, inaccordance with accepted academic practice.No use, distribution or reproduction ispermitted which does not comply with theseterms.Editorial: Rabies, a long-standingOne Health example – progress,challenges, lessons and visions onthe way to 0 by 30Anna S. Fahrion1*, Conrad M. Freuling2, Monique Léchenne3,4,Thomas Müller2, Sergio Recuenco5, Marco A. N. Vigilato6,Frank Busch1, Kathrin Heitz-Tokpa7, Stephanie Mauti3,4,Mathew Muturi8,9 and Salome Dürr101Institute for International Animal Health/One Health, Friedrich-Loe	er-Institute, Federal ResearchInstitute for Animal Health, Riems, Germany, 2Institute for Molecular Virology and Cell Biology,Friedrich-Loe	er-Institute, Federal Research Institute for Animal Health, Riems, Germany, 3Departmentof Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland,4Department of Public Health, Medical Faculty, University of Basel, Basel, Switzerland, 5Department ofPreventive Medicine and Public Health, Faculty of Medicine, Universidad Nacional Mayor de San Marcos,Lima, Peru, 6Pan American Foot and Mouth Disease and Veterinary Public Health Center, Pan AmericanHealth Organization, Rio de Janeiro, Brazil, 7Centre Suisse de Recherches Scientifiques en Côte d’Ivoire,Abidjan, Côte d’Ivoire, 8Zoonotic Disease Unit, State Directorate of Veterinary Services, Nairobi, Kenya,9Department of Veterinary Medicine, Dahlem Research School of Biomedical Sciences (DRS), FreieUniversität Berlin, Berlin, Germany, 10Veterinary Public Health Institute, Vetsuisse Faculty, University ofBern, Bern, SwitzerlandKEYWORDSrabies, veterinary public health, Zero by 30, One Health, disease elimination, neglectedtropical disease (NTD), zoonosisEditorial on the Research TopicRabies, a long-standing One Health example – progress, challenges,lessons and visions on the way to 0 by 30Rabies control requires a One Health approachRabies is a zoonosis that is endemic in most African and Asian countries and has one ofthe highest case fatality rates of any disease. More than 95% of the estimated 59,000 annualcases of rabies in humans are attributed to dog bites (1, 2). Death and suffering from rabiesare preventable, and the ambition to eliminate dog-mediated human rabies by 2030 has beenformulated as “Zero by 30”, as manifested in a Global Strategic Plan by the United AgainstRabies Coalition (3). However, even in regions that havemade great strides in eliminating thedisease, these successes remain fragile and hard to maintain if interventions are weakened orstopped because a country or region is no longer endemic (4).One Health is an integrated, unifying approach that aims to sustainably balance andoptimize the health of people, animals, and ecosystems and to generate incremental value byjoining interdisciplinary forces. This view recognizes that the health of humans, domesticand wild animals, plants, and the wider environment (including ecosystems) are closelylinked and interdependent (5). One Health approaches were proven to contribute toresilient communities and health systems long before the world was hit by the COVID-19pandemic that brought One Health to the forefront of public attention. In the case ofdog-mediated rabies, the need for close collaboration between the animal and humanFrontiers in Veterinary Science 01 frontiersin.orgFahrion et al. 10.3389/fvets.2023.1220327sectors has been evidenced and acknowledged for many years.Rabies experts have been emphasizing the importance ofcollaboration between sectors in surveillance, prevention, control,and elimination efforts even before the One Health concept becamean increasingly common position of the “Tripartite” internationalorganizations,1 in which rabies was given special relevance fromthe very beginning (6). The application of a One Health approachis also a central aspect of the global strategic plan towardselimination of dog-mediated human rabies not only as a means ofsuccessful rabies elimination but also because of the demonstratedeconomic savings.This Research Topic called for papers presenting experiences,innovative perspectives, and visions for achieving the “Zero by30” goal, with a special focus on the importance of One Healthfor rabies control, not only at the direct host-agent zoonoticinterface but also considering environmental, sociological, and(geo)political aspects. A total of 147 authors responded to thiscall and contributed to 20 publications contained in this ResearchTopic, which include original research papers (15), brief researchreports (1), perspectives (3), and opinion papers (1). The authorsreported from the global (8) to the local level, with country andsubnational examples from Benin (1), Brazil (2), Chad (2), Côted’Ivoire (1), Indonesia (1), Mexico (1), Namibia (1), Thailand (2),and the Philippines (1).Political empowerment of theveterinary sectorThe recent COVID-19 pandemic has given the One Healthparadigm an unprecedented boost in public awareness, but alltoo often only in the direction of pandemic preparedness andresponse, to the detriment of endemic and neglected diseases.Nadal, Abela-Ridder, et al. provide insights into the disruptiveeffects of the COVID-19 pandemic on rabies control, highlightingthat mass dog vaccination in 2020 was carried out as planned inonly 5% of countries surveyed, access to post-exposure prophylaxis(PEP) decreased, and under-reporting worsened in many places.The authors conclude that veterinary services now need to takethe lead in ensuring that they become an irreplaceable and integralpart of public health services at local, regional, and global levels.Djegu et al. give an example of capacity strengthening in Benin’sCentral Veterinary Laboratory through the joint efforts of nationalauthorities and inter- and non-governmental actors, leading to suchempowerment of the veterinary sector.The importance of considering thecultural contextSocial and cultural aspects play a paramount role when itcomes to zoonotic disease prevention and control, notably for those1 The so-called Tripartite Collaboration, consisting of the Food andAgriculture Organization of the United Nations (FAO), theWorld Organizationfor Animal Health (WOAH, formerly OIE), and the World Health Organization(WHO), was joined in 2022 by the United Nations Environment Programme(UNEP) to form the “Quadripartite”.that encompass close human-animal bonds, such as rabies. Nadal,Hampson, et al. highlight the importance of understanding thedifferent cultural and religious contexts in which humans relateto animals. In particular, they refer to traditional approaches totreatment, such as faith healing, and religiously motivated attitudestoward rabies, i.e., accepting a disease as an expression of adivine will. N’Guessan et al. describe factors such as health-seekingbehaviors and attitudes toward the concept of health and diseaseas determinants of rabies PEP dropout in the San-Pedro regionof Côte d’Ivoire, and Mbaipago et al. emphasize, among others,religious motives such as the perceived impurity of the dog asbarriers to treatment in the Republic of Chad. Premashthira et al.also take a look at the impact of socioeconomic factors on dogowners’ knowledge, attitudes, and practices toward dog vaccinationin Thailand.Improving dog vaccination, PEP, andrabies treatmentAs has been demonstrated for decades, rabies can be fullyprevented by vaccinating dogs (to eliminate it from the mainreservoir population) and humans (to prevent the development ofrabies after exposure). In a study from Thailand, Thanapongtarmet al. shed light on the characteristics of dog populations bydescribing the ownership correlation of free-roaming dogs. Thisknowledge can help to model dog populations with little effortand thus facilitate the planning of dog vaccination campaigns. Thework of Lugelo et al. and Wera et al. is also dedicated to thefacilitation and impact of mass vaccination of dogs by investigatingthe effectiveness of a passive cooling device on vaccine stabilityduring a field study in Tanzania and by looking into factorsinfluencing immunity in Indonesian dogs, respectively.Molini et al.focus on the complementary aspect of parenteral vaccination withoral rabies vaccines; the authors tested the immunogenicity of anoral vaccine strain in a field trial in Namibia.In the context of human vaccinations, da Silva et al. report onan ongoing reliance on PEP in Brazil, despite the fact that dograbies has not been eliminated and dog bite incidence remains high.As the use of PEP can be optimized by assessing the individualrabies risk of the bite victim, the authors advocate for closingknowledge gaps on PEP administration in collaboration with healthprofessionals while improving communication between health andveterinary authorities. This points to the cross-sectoral concept of“integrated bite-casemanagement” (IBCM), which aims to improvecase detection and treatment, as showcased by Rysava et al. andSwedberg et al. While the former describes the potential of IBCMusing an implementation case in Albay province, Philippines, thelatter tackles the issue through a qualitative (interview) approach,confirming that IBCM needs to be embedded in the local contextand cannot be implemented independently. Madjadinan et al.also used qualitative methods such as focus group discussions toillustrate barriers to PEP application following an IBCM approachand call for improvements in rabies health services and publicawareness. Knobel et al. spin the One Health concept and lookat a potential canine or human rabies therapy from a OneMedicine perspective. They argue that little progress has beenmadein treating rabies-infected patients and plead for investigationalFrontiers in Veterinary Science 02 frontiersin.orgFahrion et al. 10.3389/fvets.2023.1220327combination therapy of naturally infected dogs as a model for ahuman clinical scenario. Using the experience gained, rabies couldideally be transformed into a treatable disease. This proposal hasmade the paper the most read in this Research Topic to date.The role of wildlifeSince 1980, thanks to the involvement of human healthsystems in mass canine vaccination campaigns, Latin Americahas made the greatest progress in the elimination of dog rabies,mainly through the governance mechanism of the National RabiesProgram Directors (REDIPRA). In the majority of Latin Americancountries, there have been no human rabies deaths for years, mainlydue to decades of mass dog vaccinations. Meanwhile, the focusof infection has shifted to another interface: the one betweenhumans or domestic animals and wildlife reservoirs. Bats suchas Desmodus rotundus remain vectors of rabies in countries likeBrazil, as described by Megid et al., and Mexico, as highlightedby Ortega-Sánchez et al.. It is discussed that these species’epidemiological relevance for rabies transmission and eliminationdepends on various environmental factors, such as anthropogenicchanges, and therefore requires continued surveillance. Thisunderlines the importance of including the ecosystem as anintegrated part of the One Health approach with regard to rabiescontrol, particularly when rabies control in dogs is highly advanced.One Health solutionsThis Research Topic comes at a time when the One Healthconcept is better understood and more “popular” than ever before,as countries strive to implement One Health strategies and linkthem with their mandated plans to eliminate rabies. This canbreak down silos and encourage governments, authorities, andother stakeholders to integrate the “systems approach” into theirpolicies, resulting in shared expertise, joint action, and pooledresources. The United Against Rabies Forum (UARF) providessince 2020 a collaborative international network of partnersfrom different sectors and disciplines to improve cross-sectoralcoordination, reduce fragmentation, and support countries in theirrabies elimination efforts. Tidman, Thumbi, et al. present thebackground, concept, and strategic direction of the UARF, whileTidman, Fahrion, et al. describe the composition of the Forum andthe work carried out in the first 2 years of its existence to generateand compile approaches, tools, and materials to support countriesin their efforts to achieve Zero by 30.At local, regional, and global levels, we need more thanever a strengthened and integrated (veterinary, public, andenvironmental) health workforce to address challenges such asepidemics and climate change. Rabies control programs cancontribute to building One Health capacity, opening opportunitiesto address other zoonotic threats, such as those with pandemicpotential. Improving One Health coordination, collaboration,communication, and capacity building for rabies will contributeto this public good. To quote Ghai and Hemachudha, “It is timeto target the political sector, to ensure that temporary diseaseburden reduction is not misconstrued as progress, to ensure thata legal framework is in place and that the strategies account for therestrictions imposed by the COVID-19 pandemic. It is crucial thatcountries maintain pressure and preserve the priority status of thedisease at the country level, so that rabies can be eliminated onceand for all” [SIC].Author contributionsAF, SD, CF, ML, TM, SR, and MV edited this Research Topic.FB, KH-T, SM, and MM supported the Research Topic as topiccoordinators. AF and SDwrote this article, and all authors reviewedand complemented the manuscript and approved the submittedversion.Conflict of interestThe authors declare that the research was conducted in theabsence of any commercial or financial relationships that could beconstrued as a potential conflict of interest.Publisher’s noteAll claims expressed in this article are solely those of theauthors and do not necessarily represent those of their affiliatedorganizations, or those of the publisher, the editors and thereviewers. Any product that may be evaluated in this article, orclaim that may be made by its manufacturer, is not guaranteed orendorsed by the publisher.References1. Hampson K, Coudeville L, Lembo T, Sambo M, Kieffer A, Attlan M, et al.Estimating the global burden of endemic canine rabies. PLoS Neglect Trop Dis. (2015)9:e0003709. doi: 10.1371/journal.pntd.00037092. World Health Organization (editor). WHO Expert Consultation on Rabies. ThirdReport.WHO Technical Report Series, 1012. 3rd ed. Geneva: WHO (2018).3. Minghui R, Stone M, Semedo MH, Nel L. New global strategic plan toeliminate dog-mediated rabies by 2030. Lancet Global Health. (2018) 6:e828–9. doi: 10.1016/S2214-109X(18)30302-44. Raynor B, Díaz EW, Shinnick J, Zegarra E, Monroy Y, Mena C, et al. The impactof the COVID-19 pandemic on rabies reemergence in Latin America: the case ofArequipa, Peru. PLoS Negl Trop Dis. (2021) 15:e0009414. doi: 10.1371/journal.pntd.00094145. Adisasmito WB, Almuhairi S, Behravesh CB, Bilivogui P, BukachiSA, Casas N, et al. One Health: a new definition for a sustainable andhealthy future. PLoS Pathog. (2022) 18:e1010537. doi: 10.1371/journal.ppat.10105376. FAO, OIE, WHO. The FAO-OIE-WHO Collaboration. A Tripartite ConceptNote. (2010). Available online at https://cdn.who.int/media/docs/default-source/ntds/neglected-tropical-diseases-non-disease-specific/tripartite_concept_note_hanoi_042011_en.pdf?sfvrsn=8042da0c_1&download=true (accessed on May 5, 2023).Frontiers in Veterinary Science 03 frontiersin.org

Editorial: Rabies, a long-standing One Health example – progress, challenges, lessons and visions on the way to 0 by 30

https://refubium.fu-berlin.de/bitstream/fub188/40664/1/fvets-10-1220327.pdf

Editorial: Rabies, a long-standing One Health example – progress, challenges, lessons and visions on the way to 0 by 30

Abstract

Similar works

Full text

Available Versions

Institutional Repository of the Freie Universität Berlin