Speech by Dr. Kasai on the occasion of the ASEAN inter-sectoral workshop on rabies prevention and control
Dr. Takeshi Kasai
World Health Organization Representative to Viet Nam
15-17 October 2013, Da Nang
Dr Tran Dac Phu, Deputy Director General, GDPM, Ministry of Health, Viet Nam
Dr Nguyen Thu Thuy, Deputy Director General, Department of Animal Health, Ministry of Agriculture and Rural Development, Viet Nam
Dr Carolyn Benigno, FAO Regional Office for Asia and Pacific
Association of South East Asia Nations (ASEAN) Secretariat and Member States
Representatives of Ministries, partner Institutes/ Organizations
Ladies and gentlemen,
On behalf of the World Health Organization, for the Country Office in Viet Nam, the Western Pacific Regional Office (WPRO) and the South East Asia Regional Office (SEARO), I would like to congratulate the Government of Viet Nam for being the host for this very important event – the second ASEAN Inter-sectoral Workshop on Rabies Prevention and Control.
I also commend the efforts that the Viet Nam Ministry of Health has been showing over the years in the control of zoonotic diseases, particularly as the lead ASEAN country for rabies prevention and control.
Although rabies is 100% preventable, approximately one person dies every ten minutes from the disease, bringing the total to an estimated 55,000 rabies deaths worldwide each year, of which 55% are occurring in the Asia Pacific Region including Viet Nam. If we can eliminate human rabies from the region, it means we are reducing at least half of the global human rabies burden.
Rabies causes a significant social and economic burden in endemic countries. Dog bite is primary source of rabies infection in humans and livestock. It is estimated that approximately 15 million people in countries of the Asia Pacific region take at least one dose of rabies vaccine for post-exposure rabies prophylaxis due to exposure to suspected or rabid animals annually. Although the economic burden of animal rabies is considered high but surveillance data is missing as animal rabies is not notifiable disease in endemic countries.
There have been series of attempts to control rabies in the past fifteen years and periodically a strong momentum had been created often with donor’s financial support, however we are not successful yet. If we repeat the way as we did in the past, most likely the result will be the same. So how we could do differently this time?
To answer the question, let me highlight few key issues and share some suggestions.
First of all, to achieve ASEAN 2020 goal, we have to find the way to sustain the activities. Seven years is not long but not short. For example, while dog vaccine is cheap, required volume is huge and if donor or central government funding to be used, soon budget would dry up. We have to find the solution to overcome these challenges urgently.
Secondly, we have to be more conscious of where to put our limited financial and human resources so that we can get best outcome towards the goal. Focus might different by countries and may change by different epidemiological stages towards elimination.
Thirdly, neither animal nor human health sector alone can achieve the ASEAN 2020 goal and therefore we need to have a strong functional collaboration between animal and human health sector.
We need one plan with clear roles recognized by two sectors where both sectors need to be responsible for each other. In other words we are tested with a true collaboration.
Today, we have much more experience in working together between animal and human health sectors after having dealt with so many avian influenza events and many countries have developed collaborating mechanism through implementation of the Asia Pacific Strategy for Emerging Diseases, known as APSED.
APSED serves as instrumental workplan for Member States to achieve the core capacity as defined in the International Health Regulations (IHR). In line with APSED which adopts system approach, instead of creating new separate mechanism for rabies, we should utilize what has been built and further strengthen or develop a formal collaborative system in the interface between human and animal health sectors which is good not only for rabies but also for other zoonoses.
The context is different to the past. The ASEAN countries made commitment to work together on Rabies with a clear goal and specific objectives towards 2020. Rather than individual country works in isolation, working together brings momentum and strength, and solidarity.
WHO is fully committed to work with ASEAN and partners to support rabies control and subsequent elimination activities in the Asia Pacific region. We will continue to support Member States in developing core capacity including zoonoses required under IHR through APSED implementation and we will also organize regional activities in collaboration with partner organizations namely FAO and OIE.
We commit to follow up the outcome of this Workshop at the Asia Pacific Workshop on Multisectoral Collaboration for the Prevention and Control of Zoonoses planned in Kathmandu - Nepal from 27 to 29 November.
To that, we sincerely hope this Workshop serves as an ideal opportunity for us all to start drawing up ideas on how to think differently, proposing options on how we can do things differently to achieve the goal.
I wish you a successful Workshop!
Thank you very much
Dr. Takeshi Kasai