From l-r, Dr Abakeh, Dr Lartey, Dr Guracha and Mr Adjei addressed the journalists at World Rabies Day launch
Accra, Ghana//-As Ghana joins the rest of the world to mark this year’s World Rabies Day on 28th September, Ghanaians called for human rabies vaccine subsidies for the poor and vulnerable.
According to them, when the subsidies are implemented by the government with the help of development partners, the rabies vaccine burden on the poor and the vulnerable people would be reduced or eliminated entirely in the country.
Speaking at a press briefing in Accra to launch the 2022 World Rabies Day, Dr Lawrence Lartey of the Public Health Division of the Ghana Health Service admitted: “Human vaccines are expensive”.
Human vaccines are currently estimated to directly cost us USD$4,087,970 annually”.
He admitted: “For every exposed person who receives a Post Exposure Prophylaxis (PEP) vaccine, 50 dogs could have been vaccinated at the same cost”.
According to the World Health Organization (WHO), low awareness of the need to seek healthcare after a dog bite claims the lives of more than 70 thousand people each year, mostly in Asia and Africa.
Rabies vaccine
Veterinary doctors explained that the rabies vaccine is an active immunising agent used to prevent infection caused by the rabies virus.
The vaccine works by causing the victim’s body to produce its own protection (antibodies) against the rabies virus.
Rabies and its causes
According to https://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html, rabies is a serious illness that almost always results in death. Rabies virus infects the central nervous system.
Explaining further, the Chief Veterinary Officer of Ghana’s Ministry of Food and Agriculture, Dr Patrick Abakeh said dog mediated rabies is a zoonotic disease caused by the dog.
The disease he noted affects domestic and wild animals and is spread to people through close contact with infectious material, usually saliva via bites or scratches.
“Rabies is often viewed as a neglected disease that mostly affects disadvantaged populations whose deaths are rarely reported”, Dr Abakeh said.
However, he stated that rabies is particularly important to those in the agriculture sector as most of the deaths are in farming communities and farmers and their children are affected.
Symptoms may occur from days to years after exposure to the virus and include delirium (confusion), abnormal behaviour, hallucinations, hydrophobia (fear of water), and insomnia (difficulty sleeping), which precede coma and death, according to https://www.cdc.gov.
Prevention
The experts said rabies deaths in humans are 100% preventable through prompt and appropriate medical care. While the PEP is effective at preventing human rabies deaths, the approach is costly and can only protect individuals who have prompt access to health facilities with appropriate PEP provision.
Dr Abakeh however warned that “human rabies prevention should not rely on the PEP”.
He disclosed that in 2021 out of 76 samples submitted to the Accra Veterinary Laboratory, seven were human samples out of which four were positive, representing 57.1%.
In 2022, seven samples had been received so far and 28.5% were positive. All human rabies outbreaks have 100% case facility. However, human rabies is preventable, he assured.
What is being done to stop the spread of rabies?
Every dog must be vaccinated once every one or two years to help Ghana achieve immunity by 2030.
The critical proportion of all dogs that ought to be vaccinated is 70% to break the dog-to-dog transmission of rabies.
Dr Abakeh and Dr Lartey said mass vaccination of dogs should be preceded by evidence-based research of the dog ecology, population numbers and transmission in Ghana.
After this, adequate planning in strategy and logistics informed by policy is needed. All these must be done as quickly as necessary, considering the exigencies of the times. Community engagement and participation is key in assuring success of set targets in mass dog vaccination.
This year’s celebration according to them would be held on the theme ‘One Health, Zero Deaths’ to coincide with a recent record of cases of human rabies in the Ashanti Region of Ghana.
The “the one health approach is an intersectoral collaboration between institutions concerned with human health, animal health and environment health.
“Rabies is considered a proxy for One Health because it has the human, animal, and environmental components. This year, we want to remind ourselves of the One Health strategies and approaches, the systems, institutions, and other resources we will fall on, and what our objectives ought to be from now till the next celebration” Dr Lartey said.
From May 21 to 25, 2018, relevant stakeholders met to develop the current Ghana Rabies Control and Prevention Action Plan (2018-2030) whose goal is to use the ‘One Health Approach’ to control rabies in Ghana.
The plan highlights prevention and control of rabies, data collection and analysis, laboratory diagnosis, dog population management, information, education, and communication, intersectoral collaboration and legislation.
To this end, they appealed to all relevant stakeholders to collaborate to drive progress towards “Zero human deaths from dog-mediated rabies by 2030.”
Assistant Food and Agriculture Organisation Representative of the United Nations (FAO), Benjamin Adjei, called on the various Metropolitan, Municipal and District Assemblies (MMDAs) to come out with measures to enable the country achieve the target of rabies eradication by 2030.
A representative from World Health Organisation, Dr Guyo Guracha said the organisation regularly updates and disseminates technical guidance on rabies, citing epidemiology, surveillance, diagnostics, vaccines, safe and cost-effective immunisation, control and prevention strategies for human and animal rabies, operational programme implementation and palliative care for human rabies patients, among others.
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