Jakarta, 28 September 2024 – The World Health Organization (WHO) and Food and Agriculture Organization of the United Nations (FAO) are today calling for comprehensive action across Indonesia to stop rabies deaths in humans, emphasizing that every rabies death is preventable. The UN agencies are urging both personal protective measures and increased One Health action, including for mass dog vaccination and integrated bite case management.
Rabies is a vaccine-preventable, zoonotic viral disease that affects the central nervous system. In up to 99% of human rabies cases, dogs are responsible for virus transmission, primarily through bites. Once clinical symptoms appear, rabies is almost 100% fatal. In Indonesia, children under the age of 15 are frequent rabies victims.
Between January 2024 and July 2024, publicly accessible data show that 71 Indonesians have died from rabies. Among Indonesia’s 26 rabies-endemic provinces, East Nusa Tenggara (NTT) is the most affected, with 19 320 cases of potentially rabid animal bites in humans in 2023. This resulted in 35 rabies deaths. From January to July 2024, NTT reported 16 180 cases of potentially rabid animal bites and 27 rabies deaths.
“Communities in rabies-affected provinces must be empowered with both knowledge of and access to life-saving interventions,” said Dr N. Paranietharan, WHO Representative to Indonesia. “Since the beginning of 2023, almost 4 out of 5 Indonesians who died from rabies had not sought medical care after being bitten, simply because they were unaware of the need to do so. This must be addressed – urgently, decisively, and comprehensively.”
Any person bitten by a dog should:
- Immediately wash the wound with water and soap or detergent. If water and soap or detergent are unavailable, alcohol can also be effective.
- Fifteen minutes after washing the wound, apply an iodine-containing or anti-viral medication, if available.
- Seek treatment as soon as possible from a healthcare professional and complete all doses of rabies vaccine.
Across rabies-endemic provinces, WHO will continue to support the Ministry of Health to increase awareness of personal protective and first-aid measures, improve health worker capacity in bite case management, and enhance access to health facilities equipped with anti-rabies vaccine.
In 2024, WHO has supported bite case management training for health workers in Pontianak, West Kalimantan and is currently developing a social and behaviour change campaign in NTT specifically.
However, to prevent and eliminate dog-mediated rabies in people, mass dog vaccination – supported by effective dog population management – is the most cost-effective and efficient strategy. Globally, it has been shown that control of canine rabies can be achieved with sustained dog vaccination coverage of 70%.
“Indonesia is making progress towards rabies elimination. To further accelerate this effort, FAO is supporting the Government of Indonesia to develop a strategic operational plan for rabies elimination in Java, Bali, West Nusa Tenggara and NTT,” said Rajendra Aryal, FAO Representative for Indonesia and Timor-Leste.
One of the key strategies being piloted in these areas is oral rabies vaccination, which targets free-roaming dogs. This complements traditional mass dog vaccination programmes and aims to address challenges in reaching these dog populations. “FAO remains committed to supporting Indonesia's rabies control efforts,” added Aryal.
WHO and FAO will continue to support Indonesia to end human rabies deaths by 2030, in alignment with the global “Zero by 30” strategy, which targets both animal and human health sectors.
By implementing the strategy, affected countries will move closer to achieving Sustainable Development Goal (SDG) 3.3, “By 2030, end the epidemics of neglected tropical diseases”, and make progress towards meeting SDG 3.8 on achieving universal health coverage.