Neglected tropical diseases

Thailand committed to defeating human rabies by 2020

04 September 2017| Geneva −− Thailand has witnessed a substantial decline in the number of human rabies deaths reported from almost 200 a decade ago to fewer than 8 in 2015 thanks to high-level commitment and the accessibility of life-saving post-bite treatment (post-exposure prophylaxis, PEP) for animal bite victims.

©WHO/C. Black
Her Royal Highness Princess Chulabhorn addressing WHO

Although challenges remain, the personal involvement of Her Royal Highness Princess Chulabhorn has contributed to promoting the mass vaccination and management of dogs and enhanced awareness of rabies.

To eliminate rabies, you have to give people the knowledge they need and also teach them about their responsibilities,” said Professor Dr Her Royal Highness Princess Chulabhorn Mahidol who visited the World Health Organization’s headquarters in Geneva on Monday 28 August. “I have seen so many people die of rabies and at one point, even in my father’s palace, there were cases of rabies. I took the responsibility of looking after rabies and we are working very hard to put in place the infrastructure needed to eliminate the disease.

Her Royal Highness’ commitment celebrates the progress, innovation and leadership Thailand has shown in accelerating efforts to eliminate human rabies deaths by 2020. Her involvement has helped to engage and motivate the public to prevent rabies, from the village to province to national level.

Villages are far away from operation rooms of cities and Bangkok. We need mobile units so that we can go anywhere to provide care to people and service the dogs as appropriately as possible,” said HRH Princess Chulabhorn.

Thailand’s strategy is built on key areas that encompass all aspects of rabies control, elimination and prevention. It includes disease monitoring, prevention and control in animals and human beings; animal shelter management and integration of human–animal disease control in communities; awareness, data collection, analysis and research through its “Rabies One Data” centre; project monitoring and evaluation; and research, development and transfer of technology.

Her Royal Highness is championing a One Health approach to eliminate rabies in both Thailand and in the South-East Asia Region,” said Dr Bernadette Abela-Ridder, Team Leader of WHO’s Neglected Zoonotic Diseases unit. “This will greatly contribute to reaching our global target of zero human rabies deaths by 2030."

Role model

Today, Thailand leads South-East Asia and the world in developing and implementing novel disease control strategies such as cost- and dose-saving intradermal vaccines. It is therefore crucial that access to such treatment is made available in endemic regions, particularly among poor and rural populations.

Our most important next step is to get post-exposure prophylaxis out to the village level where it is most needed and where we could save thousands of lives,” said Dr H. Wilde, Chulalongkorn University, Bangkok, Thailand. “As the Princess pointed out, our challenge is to figure out how to sustainably vaccinate 70% of all dogs in these settings to break the cycle of dog-to-human rabies transmission.

WHO looks forward to working with HRH Princess Chulabhorn to further advocate for an end to rabies, as the world unites to achieve its goal of zero human rabies deaths by 2030. Rabies can be used as an indicator of success for the One Health approach as it combines efforts by human and veterinary health sectors.

I care for the health of people as much as I am concerned about the humane treatment of dogs. So if you want me to help you with rabies elimination, I can help you anywhere and in other countries. I am very willing,” said HRH Princess Chulabhorn.

Rabies, a fatal but vaccine preventable zoonotic disease, predominantly affects poor and rural populations in Africa and Asia. It is transmitted via bites and scratches from infected animals; dogs are responsible for around 99% of human cases.

Preventing human rabies deaths requires an effective One Health approach, namely dog vaccination to stop disease transmission at its source, and available, affordable PEP for people who are exposed.

HRH Professor Dr HRH Princess Chulabhorn Mahidol

Princess Chulabhorn is the youngest daughter of Their Majesties King Bhumibol Adulyadej and Queen Sirikit of Thailand. She is the founding President of the Chulabhorn Research Institute, which directs various national research projects in Thailand, including a rabies eradication programme, with a special project for accelerated immunization.

Her Royal Highness studied chemistry and in 1979 graduated from the Faculty of Science at Kasetsart University with a First Class Honours Bachelor of Science degree. She continued to study science at Mahidol University, where in 1985 she received her doctorate.

In 1986 she was awarded the UNESCO Albert Einstein Medal for her efforts in promoting scientific collaboration and became the first Asian to be invited to join the Royal Society of Chemistry in the United Kingdom as an Honorary Fellow. Since 1985 she has been a Professor of Chemistry at Mahidol University and a visiting lecturer in some of the world’s best known universities.

Ashok Moloo
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