SPMC Journal of Health Care Services

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EDITORIAL

Rabies-free Philippines 2020: are we there yet?

SPMC J Health Care Serv. 2015;1(1):5-6.

Seurinane Sean Española1


1Department of Family Medicine, Southern Philippines Medical Center, JP Laurel Ave, Davao City, Philippines


Correspondence Seurinane Sean Española, poet512@yahoo.com
Received 30 October 2015
Accepted 12 November 2015
Cite as Española SS. Rabies-free Philippines 2020: are we there yet? SPMC J Health Care Serv. 2015;1(1):7-8.


“When the dog bites, when the bee stings, when I'm feeling sad,
I simply remember my favorite things, and then I don't feel so bad.“


My Favorite Things. Rodgers and Hammerstein. The Sound of Music. 1959.



I wonder if included in Maria's favorite things were the trips to the doctor for rabies vaccination. Rabies infection among unvaccinated humans is almost invariably fatal. Thus, animal bites — whether by dogs, cats, livestock, or even wild bats — require rabies vaccination. Nevertheless, due to insufficient information and health education among the public, and lack of access to vaccines for humans and animals, rabies continues to be a national health concern.


The Philippines is one of the top ten countries with rabies problem,1 with an estimated 200-300 deaths annually.2 In Davao Region, there were 16 deaths in 2013 and 22 deaths last year due to human rabies infection.3 Completion of post-exposure prophylaxis (PEP) for rabies has also been a problem. In 2013, the PEP completion rate in Davao Region was 69.49%. The Philippine government started to provide all rabies vaccines for free last year, and yet, in the 2014 cohort report, the PEP completion rate dwindled to 67%.3


Republic Act 9482, or the Anti-Rabies Act of 2007, aims to address the country's ongoing concerns relating to rabies. It is "an act providing for the control and elimination of human and animal rabies, prescribing penalties for violation thereof and appropriating funds therefor."4 The law mandates the establishment of a National Rabies Prevention and Control Program (NRPCP) implemented by multiple agencies, and chaired by the Bureau of Animal Industry (BAI) of the Department of Agriculture (DA). The other agencies supporting the program include the Department of Health (DOH), Department of the Interior and Local Government (DILG), Department of Education (DepEd), local government units with the assistance of the Department of Environment and Natural Resources (DENR), as well as numerous non-governmental organizations and people's organizations.4


Activities towards controlling and eliminating rabies in the country include mass dog vaccination, establishment of a database system for vaccinated dogs, impounding, education campaign on the prevention and control of rabies, provision of rabies vaccination to animal bite victims, free routine immunizations to school aged children aged five to fourteen in high risk areas, and responsible pet ownership.4


The NRPCP has been in the forefront of efforts to control and eliminate rabies. The vision of the program is to declare Philippines rabies-free by year 2020. The DOH committed to augment the rabies vaccine supply of the DA, as expressed in a memorandum of agreement signed by both departments last 5 May 2014.5


Rabies elimination is attainable. In 2006, the province of Bohol was ranked as having the 4th highest incidence of human rabies in the Philippines, with an average of 10 deaths per year.6 In 2007, the Bohol Rabies Prevention and Elimination Project (BRPEP) was initiated. The program aimed to: increase local community involvement; implement dog population control; conduct mass dog vaccinations; improve dog bite management; institute veterinary quarantine; improve diagnostic capability; and do surveillance and monitoring. The implementation within the first 18 months of the BRPEP led to a decrease in human rabies deaths annually from 0.77, to 0.37, and then to zero per 100,000 population in 2007, 2008 and 2009, respectively. Between October 2008 and November 2010, Bohol was free of human and animal cases of rabies.6


Hence, a few more measures need to be added to the present efforts at keeping rabies at bay. It is vital that communities are involved in implementing our country's rabies elimination program. Community involvement breeds responsibility. Community-driven campaigns on the prevention and control of rabies will ensure not only the effective communication of the messages, but also a broader population that will receive the education. Impounding can work more efficiently with the active participation of the community. The establishment of animal bite centers in the community may also prove to be helpful in improving access to vaccines, in capacitating the community to handle some elements of the rabies elimination program, and in keeping program costs low. The compulsory registration of pets can establish ownership and accountability, especially when these pets do bite people. Finally, health care practitioners need to stress the importance of completion of vaccinations to patients who have been bitten by animals.


Animal bites require so much more than simply remembering our favorite things. Animal bites compel whole nations to initiate and sustain well-orchestrated programs, to deliver costly interventions, and to mobilize entire communities in order to prevent the possible infection of an age-old enemy, the rabies virus itself, and to contribute to national efforts to eliminate the virus. And then we don't feel so bad.


Article source

Commissioned


Peer review

Internal


Competing interests

None declared


Access and license

This is an Open Access article licensed under the Creative Commons AttributionNonCommercial 4.0 International License, which allows others to share and adapt the work, provided that derivative works bear appropriate citation to this original work and are not used for commercial purposes. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/


References

1. World Health Organization. Rabies in the Philippines. 2015. Available at: http://www.wpro.who.int/philippines/areas/communicable_diseases/rabies/continuation_rabies_area_page/en/. Accessed November 11, 2015.


2. National Rabies Prevention and Control Program. National Rabies Prevention and Control Program. Department of Health. Rabies in the Philippines. Available at: http://www.doh.gov.ph/national-rabies-prevention-and-control-program. Accessed November 11, 2015.


3. National Rabies Prevention and Control Program. Rabies Annual Report 2014 – Region XI. 2014.


4. Republic of the Philippines. Anti-Rabies Act of 2007, Republic Act 9482. (May 25, 2007).


5. Department of Health. DOH, DA sign MOA to achieve zero rabies by 2020. Available at: http://www.gov.ph/2014/05/05/doh-da-sign-moa-to-achieve-zero-rabies-by-2020/. Accessed November 11, 2015.


6. Lapiz SM, Miranda ME, Garcia RG, et al. Implementation of an intersectoral program to eliminate human and canine rabies: the Bohol Rabies Prevention and Elimination Project. PLoS Negl Trop Dis. 2012;6(12):e1891.


Copyright © 2015 Española SS.

     

Published
November 12, 2015

Issue
Volume 1 Issue 1 (2015)

Section
Editorial




SPMC Journal of Health Care Services


           

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