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Mexico’s feat against rabies through cross-sectoral collaboration is possible in other countries


Both
WHO and the World Organisation for Animal Health (OIE) have jointly
developed procedures to enable recognition of countries in which
progress has been made against rabies through One Health and those that
are on the verge of eliminating the disease as a public health problem.

There
are many countries that have stepped up rabies control programmes in
dogs and we want to increase the recognition of such efforts,
” said Dr Gregorio Torres, Head of the OIE Science Department. “With our updated international standards on rabies1, countries’ veterinary services can seek endorsement from OIE of their national dog-rabies control programme2, and declare3 freedom from dog-mediated rabies or freedom from rabies.

In 2018, WHO established a validation procedure for countries reaching zero human deaths from dog-mediated rabies.4
The procedure involves several steps, including close collaboration
between the Ministry of Health of the WHO Member State and the WHO
Country and Regional Office as well as WHO headquarters, in the
preparation, submission and review of the dossier.

The
WHO procedure involves review of evidence by an international expert
group, followed by an official announcement of the country’s
achievement,
” explained Dr Bernadette-Abela Ridder, WHO rabies focal point. “Both WHO or OIE procedures assist countries in gaining recognition of the progress made by their rabies programmes.

Mexico’s success can be emulated by other countries

To date, Mexico is the first and only country to be validated by WHO for eliminating rabies as a public health problem.5

The
process started when the Mexican Ministry of Health compiled a dossier
demonstrating evidence of elimination as a public health problem in
accordance with the WHO validation requirements for rabies (See chart).
The dossier was submitted to the Pan American Health Organization (PAHO)
and the WHO Country Office in Mexico. It was reviewed also by PAHO’s
Department of Communicable Diseases and Environmental Health, which
hosts the regional veterinary public health unit (PANAFTOSA) responsible
for the rabies elimination programme in the Region of the Americas.
There followed a field visit by an international group of independent
experts to review and assess the evidence submitted and national rabies
elimination efforts. The experts concluded that Mexico had met the
requirements for validation of elimination of rabies as a public health
problem, and the Director-General of WHO officially endorsed the
decision.

Example of Progress towards elimination

This achievement is not just an effort of a national agency or the Government,” said Dr Hugo Lopez-Gatell Ramirez, Deputy Director, Mexican Ministry of Public Health. “It
required a vision and full commitment from all states in Mexico and the
determination of the nation in getting rid of this problem.

The
core elements of the process for validation of elimination of rabies as
a public health problem and OIE declarations of rabies-freedom include
that:

  • rabies is notifiable,
  • state of the art surveillance is in operation,
  • 2 years of absence of rabies cases (human and/or animal),
  • prevention of importation of rabies-infected animals is in place, and,
  • presence of an effective national rabies control strategy.

To
avoid duplication of efforts, WHO and OIE agreed to mutually recognize
supporting evidence that a country submits for either procedure and
organization. For example:

  • An
    OIE endorsement of a national rabies control programme will be
    considered, if a country submits a request for WHO validation on rabies
    elimination.
  • A
    WHO validation for elimination of rabies as a public health problem can
    support a self-declaration to OIE for dog-mediated rabies freedom.
  • Finally,
    if a country has successfully self-declared freedom from dog-mediated
    rabies to OIE, it will be considered also to have validated elimination
    of dog-mediated rabies as a public health problem by WHO.

Combined
with technical guidance from international organizations, these
procedures strengthen the capacity of countries to implement rabies
elimination programmes.

Sustained
political will and community engagement are among the measures
necessary to reach the goal of “Zero by 30” and, eventually, freedom
from dog-mediated rabies.

——————————
1Infection with rabies virus. In: Terrestrial Animal Health Code (Chapter 8.14). Paris: World Organisation for Animal Health.
2Official
recognition of disease status. In: Official recognition policy and
procedures. Paris: World Organisation for Animal Health
.
3Self-declaration. In: Self‐declared disease status. Paris: World Organisation for Animal Health.
4Reaching zero human deaths from rabies. In: WHO Expert Consultation on Rabies (Chapter 12 and Annex 14). Geneva: World Health Organization (WHO Technical Report Series, No. 1012.
5Mexico is free from human rabies transmitted by dogs. Washington (DC): Pan American Health Organization; 2019. 



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