Over the last six years, Namibia has developed and implemented a national strategy to tackle rabies, with technical support from the World Organisation for Animal Health (WOAH, founded as OIE) and the Friedrich-Loeffler-Institut (FLI) in Germany, as well as funding from the German Government. The country has significantly reduced the number of rabies cases.
Namibia has shown its commitment to the fight against dog-mediated rabies for several years. Recently, during the 88th General Session of the World Organisation for Animal Health (WOAH), the World Assembly endorsed Namibia’s Official Control Programme for dog-mediated rabies, the country’s roadmap to beating the virus through careful planning and health strategy. To receive such endorsement, countries need to comply with WOAH International Standards, and their applications are carefully reviewed by the Organisation to verify the efficiency of the measures in place. This great achievement will be a strong asset for Namibia in advocating and getting support to further implement their control programme.
Challenges to rabies elimination in Namibia
The rabies virus has long concerned both animal and human health authorities in the Southern African Development Community (SADC), comprised of 16 Member States including Namibia, where there are an estimated 6,300 human deaths from rabies per year. Children are especially vulnerable to the disease. Luckily, an exposed person able to receive appropriate anti-rabies treatment (post-exposure prophylaxis) after a bite can make a full recovery, but timing is key. Yet, one of the challenges in Namibia is that sparsely populated northern regions, where rabies is particularly endemic in dogs, also has limited access to medical care.
Rabies is a zoonosis, meaning it can pass from animals to humans. Indeed, around 99% of human rabies cases are due to dog bites, so encouraging dog vaccination and more largely, responsible dog ownership, is key to combatting this deadly disease.
This is not always easy to implement as, in the Northern Communal Areas of Namibia, many people still practice a nomadic lifestyle in search of grazing areas for their herds. Their destination and timing have been shifting due to climate change, and as a result, it is harder for government officials such as the Veterinary Services to coordinate effective rabies elimination campaigns in the needed areas. Recent animal disease outbreaks in other species have also compounded these challenges, straining the available budget to cover foot and mouth disease (FMD) outbreaks, as well as respond to the COVID-19 crisis.
In working to combat dog-mediated rabies, Namibia officials needed to confront numerous issues simultaneously. Establishing accurate figures on the number of dogs and their vaccination rate in different regions has proved challenging, a direct result of high turn-over in the dog population. The accuracy of those figures and the high turn-over rate affect how a country can measure its success in dog vaccination.
Namibia makes strides against rabies
Despite these challenges, Namibia has made enormous progress in reducing the number of cases of rabies in dogs and thereby in humans within the framework of their national strategy. They started their first rabies vaccination campaign in May 2016 and were able to roll-out within the 263,000 km2 of the eight Northern Communal Areas by 2017. This region was targeted as a priority because rabies is highly concentrated in its dog population. Already the project has shown results as the number of human rabies deaths in this region dropped from 23 in 2015 (higher than the national average) prior to the project, to only two in 2019.
To further their efforts, the World Organisation for Animal Health, with the generous support of the German Federal Ministry of Food and Agriculture, donated 650,000 doses of rabies vaccine to help drive their mass dog vaccination campaigns, a core component of an efficient rabies elimination strategy. Dr Nehemia Hedimbi, the coordinator of rabies campaigns for Namibia, described that while receiving doses is critical, there are also many other challenges that the national Veterinary Services must consider in the deployment of a successful campaign. Mainly this includes the training of vaccinators and animal technicians in all regions, the shortage of transportation and available workforce, as well as the mobilisation of resources needed for the vaccination campaigns. Hoping to assuage some of these needs, over the years, WOAH has provided technical and coordination support to veterinarians in the organisation of the rabies campaigns drives and has supplied needed tools to get the job done efficiently, such as diagnostic materials and electronics.
The Veterinary Authorities of Namibia did not work in isolation. Knowing that the porous border between Angola and Namibia allow for the propagation of rabies in dogs in both countries, the two teamed up in their elimination efforts. By 2019, they had come together to conduct a joint technical committee between their national Veterinary Services. The two countries developed a rabies elimination plan for Southern Angola and a cross-border harmonisation plan, both of which are meant to help lessen the incidence of dog-mediated rabies. To further this result, WOAH donated 140,000 doses of rabies vaccine to Angola with the support of the European Union. Reflecting on the experience, Dr Hedimbi is pleased with their progress noting that working with other nations on a common health problem can be tricky. “Other countries have different priorities,” he says. “Some countries do not have a National Rabies Control Strategy and some lack vaccination campaigns.” In a true South-to-South collaboration, Namibia provided technical support to Angola on rabies, and shared rabies vaccines for dogs. They also invited Angolan colleagues to planning and monitoring meetings on rabies to stay informed. Most importantly, both countries are now in constant contact to inform of new rabies cases along their shared border.
The pathway to dog-mediated rabies elimination in Namibia
Looking forward, Namibia will not be slowing down their efforts, hoping that rabies elimination lies not too far in their future. Dr Hedimbi is optimistic, relating that “if Namibia dedicates the necessary resources and efforts, dog-mediated rabies will soon be reduced to the elimination stage”. This would include hosting more dog vaccination campaigns, improving dog population management and certainly implementing more awareness campaigns in the country, as well as working hand in hand with the human health sector under a One Health approach. Every year Namibia will share an annual progress report on these rabies activities with WOAH to receive reconfirmation of their status which will further governmental advocacy. With the WOAH endorsement of their Official Control Programme, the country is well on its way to creating a safer, healthier future for its citizens, both human and canine.