Bangladesh tackles rabies through mass dog vaccination

September 2014

Bangladesh’s canine vaccination programme aims to break the cycle of rabies transmission from dogs to humans.

A child holding a dog
Huzzatul Mursalin

One morning, Rubaiya Ahmad awoke to the news that Kashtanka—a street dog she had adopted and cared for since birth—had been taken away by local authorities in Dhaka. Later that day, she found her beloved dog in the back of a pick-up truck, en route to a city landfill.

It was a painful sight that remains etched in Rubaiya’s memory: “Kashtanka's body had been tossed in a pile of about 60 dead dogs,” she recalls.

Rubaiya was incensed. Her dog had been registered with city authorities, vaccinated, sterilized and collared. She was healthy and well fed. Why did they kill Kashtanka?

She soon learned that the government of Bangladesh had been killing dogs indiscriminately in an attempt to eliminate rabies—a practice that had gone on for decades. “This was the accepted, government-funded mechanism for controlling rabies across the country,” notes Rubaiya.

The strategy wasn’t working. Bangladesh, at the time, had one of the highest rates of rabies-related human deaths in the world.

Saving street dogs

After losing Kashtanka, Rubaiya left a comfortable job to advocate for a cause she believed in passionately: animal rights. In 2009, she founded Obhoyaronno, a non-governmental organization dedicated to saving street dogs.

“In the beginning, when we talked about animal welfare, there was little interest,” Rubaiya recalls. “But when we talked about rabies control, people started listening. So we changed our pitch.”

Together with partners such as Humane Society International and the Food and Agriculture Organization, Rubaiya promoted the WHO-recommended approach of preventing rabies through dog vaccination. Speaking with Ministry of Health officials, she highlighted other countries that had successfully adopted this model, such as India and Sri Lanka.

In time, her efforts paid off. Beginning in late 2011, as part of a new national rabies elimination strategy, the government of Bangladesh began vaccinating—rather than killing—dogs on a large scale.

A shift in strategy

Bangladesh’s mass canine vaccination programme aims to break the cycle of transmission from dogs to humans. Evidence has shown that this can be achieved by reaching 70% of a dog population with 3 rounds of vaccinations.

“So far, it’s been smooth sailing,” says Professor Be-Nazir Ahmed, Director of Disease Control in Bangladesh’s Ministry of Health and Welfare. Following a successful WHO-supported pilot project in Cox's Bazaar, a district of Bangladesh, the government is now vaccinating dogs in nearly all 64 districts in the country.

Many former dog killers have been trained by the government as friendly dog catchers. More than 1000 expert dog catchers across the country now focus on vaccinating dogs before returning them to their owners, or to the place where they were caught.

Despite progress in the dog vaccination programme, financing remains a major challenge. Increased funding from both government and non-government sources will be critical to ensure its continued success, notes Be-Nazir.

Prevention is key

Under the national plan, people who have been bitten by a dog bite can access anti-rabies vaccines, free of charge, at health centres in all 64 districts of the country.

But prevention is at the heart of the national strategy, and one look at the price tag explains why. Preventing the transmission of rabies through dog vaccination costs, on average, US $3 per dog. Vaccinating the country’s 1.2 million dogs would involve a one-time cost of approximately $3.6 million.

Treating rabies costs, on average, US$32 to $92 per person—a cost that would be borne over an indefinite period of time. Unless rabies is controlled at the source, treatment costs are expected to rise.

Raising awareness

Building awareness of rabies, and the importance of prevention, is a key aim of the national plan. To that end, the government of Bangladesh and its development partners will mark this year’s World Rabies Day—September 28—with educational programmes in more than 50 000 primary schools across the country and through a series of press conferences, seminars and rallies.

Early results

The national plan identifies 2 key targets: reducing human deaths by 90% by 2015 and eliminating rabies by 2020. Results, to date, are encouraging. Before 2010, there were an estimated 2000 rabies-related human deaths reported annually in Bangladesh. According to government figures, the number of deaths fell by approximately 50% between 2010 and 2013.

The global picture

Thousands of people die from rabies each year, mostly in Africa and Asia. Children under age 15 are particularly vulnerable, accounting for 4 out of every 10 rabies-related deaths.

If a person is bitten by a rabid animal, WHO recommends immediate and thorough cleansing of the wound, multiple rabies vaccine injections and, in cases of severe exposure, administration of rabies immunoglobulin.

Symptoms of rabies—which include fever, hyperactivity, excited behaviour, difficulty swallowing or paralysis—may appear any time between 2 to 8 weeks after the bite. Once a person develops symptoms, the outcome is nearly always fatal.