4.5 Article

Rabies control in Liberia: Joint efforts towards zero by 30

Journal

ACTA TROPICA
Volume 216, Issue -, Pages -

Publisher

ELSEVIER
DOI: 10.1016/j.actatropica.2020.105787

Keywords

Rabies; Liberia; Diagnostic; Phylogenetics; SARE tool; GDREP tool

Funding

  1. Global Alliance for Vaccines and Immunisation (GAVI) [VISLACRV19122014]
  2. Wolfermann Nageli Foundation
  3. Swiss African Research Cooperation (SARECO)
  4. Stay on Track of the University of Basel
  5. USAID

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Despite being declared a national priority disease, dog rabies remains endemic in Liberia, with efforts being made to establish animal rabies diagnostics and vaccination programs. With an estimated investment of 5.3-8 million USD over 13 years, Liberia aims to eliminate rabies by 2030 through a comprehensive action plan developed in collaboration with various stakeholders.
Despite declaration as a national priority disease, dog rabies remains endemic in Liberia, with surveillance systems and disease control activities still developing. The objective of these initial efforts was to establish animal rabies diagnostics, foster collaboration between all rabies control stakeholders, and develop a short-term action plan with estimated costs for rabies control and elimination in Liberia. Four rabies diagnostic tests, the direct fluorescent antibody (DFA) test, the direct immunohistochemical test (dRIT), the reverse transcriptase polymerase chain reaction (RT-PCR) assay and the rapid immunochromatographic diagnostic test (RIDT), were implemented at the Central Veterinary Laboratory (CVL) in Monrovia between July 2017 and February 2018. Seven samples (n=7) out of eight suspected animals were confirmed positive for rabies lyssavirus, and molecular analyses revealed that all isolates belonged to the Africa 2 lineage, subgroup H. During a comprehensive in country One Health rabies stakeholder meeting in 2018, a practical workplan, a short-term action plan and an accurately costed mass dog vaccination strategy were developed. Liberia is currently at stage 1.5/5 of the Stepwise Approach towards Rabies Elimination (SARE) tool, which corresponds with countries that are scaling up local-level interventions (e.g. dog vaccination campaigns) to the national level. Overall an estimated 5.3-8 million USD invested over 13 years is needed to eliminate rabies in Liberia by 2030. Liberia still has a long road to become free from dog-rabies. However, the dialogue between all relevant stakeholders took place, and disease surveillance considerably improved through implementing rabies diagnosis at the CVL. The joint efforts of diverse national and international stakeholders laid important foundations to achieve the goal of zero dog mediated human rabies deaths by 2030.

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