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Mexico’s action against rabies through cross-sectoral cooperation is also possible in other countries
Both the WHO and the World Organization for Animal Health (OIE) have jointly developed procedures to enable the identification of countries where progress has been made against rabies through One Health and those on the brink of eliminating the disease as a public health problem.
“There are many countries that have stepped up rabies control programs in dogs and we want to increase the recognition of such efforts,“Said Dr. Gregorio Torres, head of the RES Department of Science.”With our updated international standards on rabies1, country veterinary services may request RES approval from
their national dog and rabies control program2, and declare3 freedom from rabies mediated by dogs or freedom from rabies.“
In 2018, the WHO established a certification process for countries that have reached zero human mortality due to dog-mediated rabies.4 The process involves several steps, including close cooperation between the WHO Member State’s Ministry of Health and the country and the WHO Regional Office, as well as WHO headquarters, in the preparation, submission and review of dossiers.
“The WHO process involves reviewing the evidence of an international expert group, followed by an official announcement of the country’s achievements,“Explained Dr. Bernadette-Abela Ridder, the focus of WHO rabies. “Both WHO or RES procedures help countries recognize the progress made in their rabies programs.”
Mexico’s success can be emulated by other countries
To date, Mexico is the first and only country confirmed by the WHO to eliminate rabies as a public health problem.5
The process began when the Mexican Ministry of Health compiled a dossier showing evidence of removal as a public health problem in line with WHO requirements for rabies testing (see table). The documentation was submitted to the Pan American Health Organization (PAHO) and the WHO Office in Mexico. The review was also reviewed by the Department of Infectious Diseases and Environmental Health of PAHO, which hosts the Regional Veterinary Public Health Unit (PANAFTOSA) responsible for the rabies eradication program in the Americas region. This was followed by a field visit by an international group of independent experts to review and evaluate the evidence submitted and national efforts to eradicate rabies. Experts concluded that Mexico met the conditions for evaluating the elimination of rabies as a public health problem, and the WHO Director-General officially approved the decision.
An example of progress towards removal
“This achievement is not just the effort of a national agency or government,“Said Dr. Hugo Lopez-Gatell Ramirez, Deputy Director, Mexican Ministry of Public Health.”What was needed was the vision and complete commitment of all the states in Mexico and the determination of the nation to solve this problem.”
The basic elements of the validation process for the elimination of rabies as a public health problem and the RES Declaration on Freedom against Rabies include:
- rabies is reported,
- state-of-the-art monitoring is underway,
- 2 years of absence of rabies cases (humans and / or animals),
- the importation of animals infected with rabies is prevented, and
- the presence of an effective national rabies control strategy.
To avoid duplication of effort, the WHO and the RES agreed to mutually acknowledge the corroborating evidence submitted by the state for any procedure and organization. For example:
- The RES confirmation of the national rabies control program will be considered if the country applies for a WHO certificate on rabies eradication.
- WHO endorsement of rabies eradication as a public health problem may support the self-proclaimed RES for dog-mediated rabies freedom.
- Finally, if a country has successfully self-proclaimed freedom from dog-mediated rabies to the OIE, it will be considered that the WHO will confirm the elimination of dog-mediated rabies as a public health problem.
Combined with technical guidance from international organizations, these procedures strengthen countries’ ability to implement rabies eradication programs.
Sustained political will and community engagement are one of the measures needed to achieve the “Zero to 30” goal and, ultimately, freedom from dog-mediated rabies.
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1Rabies virus infection. In: Code of Health Services for Terrestrial Animals (Chapter 8.14). Paris: World Organization for Animal Health.
2Official recognition of disease status. In: Official Policy and Recognition Procedures. Paris: World Organization for Animal Health.
3Self-declaration. In: Self-declared disease status. Paris: World Organization for Animal Health.
4Reaching zero human death from rabies. In: WHO Expert Advice on Rabies (Chapter 12 and Annex 14). Geneva: World Health Organization (WHO Technical Report Series, No. 1012).
5Mexico is free of human rabies transmitted by dogs, Washington (DC): Pan American Health Organization; 2019th
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