Gavi, the Vaccine Alliance, in collaboration with partners, is announcing support for human rabies vaccines for post exposure prophylaxis (PEP) as part of routine immunisation. Eligible countries are receiving guidance on how to access these vaccines under Gavi's cofinancing policy. The first round of applications will be accepted by mid- July 2024. Ninety-five percent of human rabies deaths occur in Africa and Asia, most often in marginalised communities that lack access to care.
This development complements ongoing global efforts of the Zero by 30 campaign, led by United Against Rabies partners including the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH, formerly OIE) with the goal of eliminating dog-mediated human rabies by 2030.
"This commitment from Gavi is crucial and will expedite efforts to halt human fatalities caused by dog-mediated rabies," said Dr Jérôme Salomon, Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases at WHO. "WHO will provide technical assistance to countries, not only to support their funding applications to Gavi but to draw up comprehensive plans of action that can deliver real progress towards the Zero by 30 goal."
In more than 150 countries where dog rabies remains a serious public health problem, stocks of human rabies vaccines in public health systems are often extremely limited, especially in marginalised communities. Where human rabies vaccine is available through private facilities, the cost of PEP can impose a catastrophic financial burden on families and communities.
"Gavi's aim with this program is to contribute to global rabies efforts and save lives by helping countries ensure that human rabies vaccines are available to anyone who needs them and that vulnerable and marginalised communities have equal access to these essential medicines," said Aurélia Nguyen, the Chief Programme Officer at Gavi, the Vaccine Alliance.
Rabies is a viral disease that causes severe inflammation of the brain. In 99% of cases, it is transmitted to humans by a rabid dog. Once the virus reaches the central nervous system and an infected person shows clinical symptoms, rabies infection is near 100% fatal.
The deadly nature of rabies and its traumatic symptoms make it one of the world's most feared diseases. However, rabies infection is preventable by prompt PEP, which consists of thorough wound washing, administration of a course of good quality human rabies vaccine, and immunoglobulins if needed.
Gavi initially agreed to include human rabies vaccines for PEP in its 2021-25 Vaccine Investment Strategy, however the COVID-19 pandemic led to postponement of the program until mid-2023, when the decision to restart was made by Gavi's Board.
"Gavi's investment is hugely important and underpins a key pillar of the global strategy to stop people dying from this terrible disease," said Professor Lucille Blumberg, Chair of United Against Rabies. "But to stop human rabies deaths completely, we urgently need better data and surveillance, dog populations must be vaccinated, and people must be educated about what to do if bitten, and how to avoid being bitten in the first place. Stopping human deaths from rabies is within our reach, but it will take multiple sectors working together to achieve it."
All Gavi-eligible countries can apply for support to invest in human rabies vaccines for PEP. Funding will be available for vaccine procurement and associated supplies. Rabies immunoglobulins (RIG) and dog vaccines are not covered by this program. Countries are not required to have a national rabies control plan in place to apply for the first round of multiyear funding, but a national plan will be mandatory for all subsequent applications.
Funding applications will be accepted by Gavi in 2024 by 15 July and by 23 September 2024, with subsequent funding windows open three times every year.
