{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T06:10:46Z","timestamp":1791958246340,"version":"4.3.4"},"reference-count":53,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T00:00:00Z","timestamp":1612915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1127988"],"award-info":[{"award-number":["OPP1127988"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Nearly 59,000 human deaths worldwide are attributable to rabies annually, of which more than a third occur in Africa. In recent years, progress has been made in both action and collaboration including implementation of surveillance and prevention measures. In this review we assess the scale of surveillance, preventive, and control efforts of canine-transmitted human rabies in African countries. We reviewed literature published from 2014 to 2018, retrieved from electronic databases including MEDLINE, Global Index Medicus, BIOSIS, Science Citation Index, and EMBASE. WHO reports, national disease control program reports, and conference proceedings were also reviewed. The database search was conducted using keywords including rabies, control, and prevention. In forty countries (40\/54), some level of rabies control and prevention strategy was available while in fourteen (14\/54) countries, no specific national control and prevention strategy for human rabies could be retrieved. Thirty-four (34\/54) countries utilized the Stepwise Approach towards Rabies Elimination (SARE) tool to monitor the national rabies control efforts\u2014five of these countries were at the lowest tier (0\/5) of the SARE scoring system while no country had achieved the highest score (5\/5). High burden countries need to step up the implementation of context specific national rabies control, prevention, and monitoring strategies. As a zoonosis, rabies control and elimination require coordination between human and veterinarian health sectors under the \u201cOne Health\u201d umbrella and with national master plans on the prevention and control of neglected tropical diseases ending in 2020, the time to act is now.<\/jats:p>","DOI":"10.3390\/ijerph18041736","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:49:26Z","timestamp":1613090966000},"page":"1736","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Challenges to the Fight against Rabies\u2014The Landscape of Policy and Prevention Strategies in Africa"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1740-0011","authenticated-orcid":false,"given":"Andrea Haekyung","family":"Haselbeck","sequence":"first","affiliation":[{"name":"International Vaccine Institute, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Rietmann","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4005-8605","authenticated-orcid":false,"given":"Birkneh Tilahun","family":"Tadesse","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Kling","sequence":"additional","affiliation":[{"name":"Immunization Unit, Robert Koch Institute, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Elena","family":"Kaschubat-Dieudonn\u00e9","sequence":"additional","affiliation":[{"name":"Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Center for Veterinary Public Health, Freie University Berlin, 14163 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Marks","sequence":"additional","affiliation":[{"name":"International Vaccine Institute, Seoul 08826, Korea"},{"name":"Laboratory of Microbiology and Parasitology, University of Antananarivo, 566 Antananarivo, Madagascar"},{"name":"Cambridge Institute of Therapeutic Immunology and Infectious Disease, University of Cambridge School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0SL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1474-6930","authenticated-orcid":false,"given":"Wibke","family":"Wetzker","sequence":"additional","affiliation":[{"name":"Clinic for Anaesthesiology and Intensive Care Medicine, Jena University Hospital, 07743 Jena, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0782-2755","authenticated-orcid":false,"given":"Christa","family":"Th\u00f6ne-Reineke","sequence":"additional","affiliation":[{"name":"Institute of Animal Welfare, Animal Behavior and Laboratory Animal Science, Center for Veterinary Public Health, Freie University Berlin, 14163 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1136\/vr.h4196","article-title":"Rabies: 100 per cent fatal, 100 per cent preventable","volume":"177","year":"2015","journal-title":"Vet. Rec."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hampson, K., Coudeville, L., Lembo, T., Sambo, M., Kieffer, A., Attlan, M., Barrat, J., Blanton, J.D., Briggs, D.J., and Cleaveland, S. (2015). Estimating the global burden of endemic canine rabies. PLoS Negl. Trop. Dis., 9.","DOI":"10.1371\/journal.pntd.0003786"},{"key":"ref_3","unstructured":"World Health Organization (2018). WHO Expert Consultation on Rabies, Third Report, World Health Organization. Licence: CC BY-NC-SA 3.0 IGO."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1016\/S0140-6736(13)62707-5","article-title":"Current status of rabies and prospects for elimination","volume":"384","author":"Fooks","year":"2014","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/tbed.12168","article-title":"The Cost of Canine Rabies on Four Continents","volume":"62","author":"Anderson","year":"2015","journal-title":"Transbound. Emerg. Dis."},{"key":"ref_6","unstructured":"United Nations (2015). Transforming Our World: The 2030 Agenda for Sustainable Development, Division for Sustainable Development Goals."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"A154","DOI":"10.1016\/j.vaccine.2018.11.035","article-title":"The impact of transmission dynamics of rabies control: Systematic review","volume":"37","author":"Rattanavipapong","year":"2019","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"A146","DOI":"10.1016\/j.vaccine.2018.11.071","article-title":"Cost-effectiveness modelling studies of all preventive measures against rabies: A systematic review","volume":"37","author":"Anothaisintawee","year":"2019","journal-title":"Vaccine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/S1473-3099(18)30512-7","article-title":"The potential effect of improved provision of rabies post-exposure prophylaxis in Gavi-eligible countries: A modelling study","volume":"19","author":"Hampson","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1080\/14760584.2019.1627205","article-title":"Current status of human rabies prevention: Remaining barriers to global biologics accessibility and disease elimination","volume":"18","author":"Rupprecht","year":"2019","journal-title":"Expert Rev. Vaccines"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Collinson, A., Bennett, M., Brennan, M.L., Dean, R.S., and Stavisky, J. (2020). Evaluating the role of surgical sterilisation in canine rabies control: A systematic review of impact and outcomes. PLoS Negl. Trop. Dis., 14.","DOI":"10.1371\/journal.pntd.0008497"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"145","DOI":"10.20506\/rst.38.1.2949","article-title":"Importance of a One Health approach in advancing global health security and the Sustainable Development Goals","volume":"38","author":"Sinclair","year":"2019","journal-title":"Rev. Sci. Tech. Int. Off. Epizoot."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.antiviral.2015.10.002","article-title":"The Pan-African Rabies Control Network (PARACON): A unified approach to eliminating canine rabies in Africa","volume":"124","author":"Scott","year":"2015","journal-title":"Antivir. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1146\/annurev-ecolsys-110512-135813","article-title":"The Evolution of Animal Domestication","volume":"45","author":"Larson","year":"2014","journal-title":"Annu. Rev. Ecol. Evol. Syst."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1668","DOI":"10.1016\/j.vaccine.2017.02.014","article-title":"Rationale and support for a One Health program for canine vaccination as the most cost-effective means of controlling zoonotic rabies in endemic settings","volume":"35","author":"Lavan","year":"2017","journal-title":"Vaccine"},{"key":"ref_16","unstructured":"FAO (2013). Developing a stepwise approach for rabies prevention and control. FAO Animal Production and Health Proceedings, Proceedings of the FAO\/GARC Workshop, Rome, Italy, 6\u20138 November 2012, FAO."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"751","DOI":"10.20506\/rst.37.2.2838","article-title":"The role of non-governmental organisations in controlling rabies: The Global Alliance for Rabies Control, Partners for Rabies Prevention and the Blueprint for Rabies Prevention and Control","volume":"37","author":"Nel","year":"2018","journal-title":"Rev. Sci. Tech. Int. Off. Epizoot."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Lembo, T., and Partners for Rabies Prevention (2012). The Blueprint for Rabies Prevention and Control: A Novel Operational Toolkit for Rabies Elimination. PLoS Negl. Trop. Dis., 6.","DOI":"10.1371\/journal.pntd.0001388"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.prevetmed.2018.07.011","article-title":"The epidemiology of dog rabies in Algeria: Retrospective national study of dog rabies cases, determination of vaccination coverage and immune response evaluation of three commercial used vaccines","volume":"158","author":"Yahiaoui","year":"2018","journal-title":"Prev. Vet. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.nmni.2019.01.001","article-title":"Epidemiology of dog-mediated zoonotic diseases in Algeria: A One Health control approach","volume":"28","author":"Kardjadj","year":"2019","journal-title":"New Microbes New Infect."},{"key":"ref_21","unstructured":"Ministry of Health Eritrea (2015). National Master Plan for Neglected Tropical Diseases 2015\u20132020, Ministry of Health Eritrea."},{"key":"ref_22","unstructured":"Ghana Health Services\u2014Public Health Division (2016). Master Plan for Neglected Tropical Diseases Programme, Ghana (2016\u20132020), Public Health Division."},{"key":"ref_23","unstructured":"The Republic of Liberia\u2014Ministry of Health (2016). Master Plan for Neglected Tropical Diseases 2016\u20132020, Ministry of Health."},{"key":"ref_24","unstructured":"Republic of Mali Ministere du Sante (2017). Mali Plan Directeur de Lutte Contre les Maladies Tropicales N\u00e9glig\u00e9es (M.T.N.) 2017\u20132021, Republic of Mali Ministere du Sante."},{"key":"ref_25","unstructured":"Republique du Niger Ministere de la Sante Publique (2016). Plan Directeur de Lutte Contre les Maladies Tropicales Negligees Niger 2016\u20132020, Republique du Niger Ministere de la Sante Publique."},{"key":"ref_26","unstructured":"Republic of Nigeria\u2014Ministry of Health (2015). Neglected Tropical Diseases Nigeria Multi\u2014Year Master Plan 2015\u20132020, Ministry of Health."},{"key":"ref_27","unstructured":"Ministry of Health (2016). South Sudan National Master Plan for Neglected Tropical Diseases 2016\u20132020, Ministry of Health."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Tricou, V., Bouscaillou, J., Kamba Mebourou, E., Koyanongo, F.D., Nakoun\u00e9, E., and Kazanji, M. (2016). Surveillance of Canine Rabies in the Central African Republic: Impact on Human Health and Molecular Epidemiology. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004433"},{"key":"ref_29","unstructured":"Republique Democratique du Congo\u2014Ministere de la Sante Publique (2016). Plan Strategique de Lutte Contre les Maladies Tropicales Negligees a Chimiotherapie Preventive 2016\u20132020, Ministere de la Sante Publique."},{"key":"ref_30","unstructured":"Ministry of Health and the Social Welfare, Republic of the Gambia (2015). National Master Plan for Neglected Tropical Diseases 2015\u20132020, Ministry of Health and the Social Welfare."},{"key":"ref_31","unstructured":"Direccao Geral da Saude Publica, Republica da Guine-Bissau MdSP (2014). Plan Directeur de Lutte Contre les Maladies Tropicales Negligees en Guinee Bissau (2014\u20132020), Direccao Geral da Saude Publica."},{"key":"ref_32","unstructured":"Republique du Senegal\u2014Ministere de la Sante et de l\u2019action Sociale (2016). Plan Strat\u00e9gique de Lutte Contre les Maladies Tropicales N\u00e9glig\u00e9es 2016\u20132020, Ministere de la Sante et de l\u2019action Sociale."},{"key":"ref_33","unstructured":"Republic of Kenya\u2014Ministry of Health and Ministry of Agriculture Livestock and Fisheries Zoonotic Disease Unit (2014). Strategic Plan for the Elimination of Human Rabies in Kenya 2014\u20132030, Ministry of Health and Ministry of Agriculture Livestock and Fisheries Zoonotic Disease Unit."},{"key":"ref_34","unstructured":"Ministry of Health (2016). The 2nd Kenya National Strategic Plan Forcontrol of Neglected Tropical Diseases 2016\u20132020, Revised ed., Ministry of Health."},{"key":"ref_35","unstructured":"The Kingdom of Swaziland (2015). Masterplan towards the Elimination of Neglected Tropical Diseases 2015\u20132020, Ministry of Health."},{"key":"ref_36","unstructured":"Royame du Maroc Ministere de la Sante (2012). Programme National de Lutte Contre la Rage, Royame du Maroc Ministere de la Sante."},{"key":"ref_37","unstructured":"Republique Tunisienne Minstere de la Sante (2018). La Commision National de Lutte Contre la Rage\u2014Programme National de la Lutte Contre la Rage, Republique Tunisienne Minstere de la Sante."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3389\/fvets.2017.00021","article-title":"Toward Elimination of Dog-Mediated Human Rabies: Experiences from Implementing a Large-scale Demonstration Project in Southern Tanzania","volume":"4","author":"Mpolya","year":"2017","journal-title":"Front. Vet. Sci."},{"key":"ref_39","unstructured":"Assenga, J.A., and Markalio, G.P. (2019, February 14). Review of National Rabies Control Efforts: Tanzania, Available online: https:\/\/rabiesalliance.org\/sites\/default\/files\/resources\/2017-06\/Tanzania%20Country%20report.pdf."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Ntampaka, P., Nyaga, P.N., Niragire, F., Gathumbi, J.K., and Tukei, M. (2019). Knowledge, attitudes and practices regarding rabies and its control among dog owners in Kigali city, Rwanda. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0210044"},{"key":"ref_41","unstructured":"Ntegeyibizaza, S. (2019, February 20). 1st Meeting of Directors of Rabies Control Progroams in East Africa, Rwanda Presentation. Available online: https:\/\/rabiesalliance.org\/sites\/default\/files\/resources\/2017-06\/Rwanda%20Country%20report.pdf."},{"key":"ref_42","unstructured":"Republic of Uganda (2018). Uganda One Health Strategic Plan 2018\u20132022, Ministry of Health."},{"key":"ref_43","unstructured":"Parodi, P., Telma, D., Daniel, S., Di Giuseppe, P., del Negro, E., and Scacchia, M. (2016, January 17\u201318). Rabies in Angola: A One health Approach. Proceedings of the One Health for the Real World: Zoonoses, Ecosystems and Wellbeing, London, UK."},{"key":"ref_44","unstructured":"Unknown (2019, February 20). Rabies Stakeholder Meeting, 2018 West Africa. Available online: https:\/\/rabiesalliance.org\/resource\/elma-zanamwerabies-stakeholder-meetings-faoparacon-2018."},{"key":"ref_45","unstructured":"Mutorwa, J. (2015). Official and Public Launch of the Directorate of Veterinary Services\u2019 Rabies Control Strategy, Ministry of Agriculture, Water and Forestry."},{"key":"ref_46","unstructured":"Bobo, G. (2018). Efforts to Eliminate dog-mediated Human Rabies Intensifies, Food and Agriculture Organization of the United Nations."},{"key":"ref_47","unstructured":"Republica de Guinea Ecuatorial (2017). Guinea Ecuatorial\u2014Plan Directeur de Lutte Contre les Maladies Tropicales N\u00e9glig\u00e9es (MTN) 2018\u20132022, Ministere de la Sant\u00e9 et Bien \u00catre Social."},{"key":"ref_48","unstructured":"Ministry of Health Malawi (2014). Malawi NTD Master Plan 2015\u20132020, Ministry of Health Malawi."},{"key":"ref_49","unstructured":"Ministry of Health Seychelles (2014). Seychelles Neglected Tropical Diseases Master Plan 2015\u20132020, Ministry of Health Seychelles."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Coetzer, A., Coertse, J., Makalo, M.J., Molomo, M., Markotter, W., and Nel, L.H. (2017). Epidemiology of Rabies in Lesotho: The Importance of Routine Surveillance and Virus Characterization. Trop. Med. Infect. Dis., 2.","DOI":"10.3390\/tropicalmed2030030"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.antiviral.2016.09.011","article-title":"The SARE tool for rabies control: Current experience in Ethiopia","volume":"135","author":"Coetzer","year":"2016","journal-title":"Antivir. Res."},{"key":"ref_52","unstructured":"World Health Organization, Food and Agriculture Organization of the United Nations, and World Organisation for Animal Health (2018). Zero by 30: The Global Strategic Plan to End Human Deaths from Dog-Mediated Rabies by 2030, World Health Organization."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"877","DOI":"10.7196\/SAMJ.2020.v110i9.14324","article-title":"Epidemiology of Human Rabies in South Africa, 2008\u20132018","volume":"110","author":"Weyer","year":"2020","journal-title":"S. Afr. Med. J."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1736\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:22:42Z","timestamp":1760160162000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/4\/1736"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,10]]},"references-count":53,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,2]]}},"alternative-id":["ijerph18041736"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18041736","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,10]]}}}