Improving the implementation and operation of a One Health platform to combat rabies in Malawi

Rabies is a neglected zoonotic disease and is, perhaps, the deadliest of all infections. It has a global burden of 60 000 deaths per year, of which 40% are children. These mostly occur in Low and Middle-Income Countries (LMICs), and more than 95 percent of the cases result from dog bites. With large-scale vaccination, canine rabies has been eliminated in many countries. However, rabies remains a feared zoonotic disease in LMICs across Africa and Asia, where deaths are also likely under-reported.

In Malawi, three in every 100,000 people die of rabies annually. With 500 registered deaths per year, rabies is estimated to cost the country 13 million USD per year due to post-exposure prophylaxis (PEP), dog vaccinations and population management, livestock losses and surveillance, and lost income and productivity from premature deaths. In 2015, the five pillars for elimination of dog-mediated rabies in humans (STOP- R) were developed: 1) Sociocultural, 2) Technical, 3) Organisational, 4) Political and 5) Resources. Tripartite collaboration (WHO, OIE and FAO) have since developed a global strategic plan to achieve zero human dog-mediated rabies deaths by 2030, “Zero by 30” through mass vaccination of dogs to achieve 70% coverage, public awareness and PEP for humans. However, despite intervention initiatives, no African country is free from rabies, mainly due to unsuccessful long-term implementation of measures and a disconnected approach to the varying factors affecting human and dog relations.

With partnerships across Malawi, Norway and the UK, this research project takes a multi-disciplinary and cross-sector approach to talking the prevention of rabies in Malawi. The project is led by Dr. Hannah J. Jørgensen, a vetinerarian from the Norwegan Institute of Vetinrary Sciences. At the University of Glasgow, Professor Mia Perry co-leads a work package with Dr Nai Ru Chng that addresses the relationship between communities and community-based organisations and the experience, awareness and engagement with rabies control and prevention measures in Malawi. 

This work aims to investigate how communities understand and practices One Health, and explore the potential for community based organisations to engage in one health roles that can address rabies elimination in Malawi. Through desk based and community participatory research this project is establishing partnerships and data to interact with the epidemiological and demographic information generated in other parts of the project.

A central part of this work involes a PhD study, carried out by Mr Bosco Chinkonda at the University of Glasgow titled: Ulongo waWandu ni Mbwaa1: A Posthumanist Reflection on Community Participation in Rabies Control in Balaka, Malawi.

 

This Project is funded by the Norwegian Funding Council

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