The Hidden Cost of the Silent Killer

In many ways, rabies takes advantage of the special relationship between man and dog. The two species have lived in close quarters and relied on each other for protection, food and companionship for thousands of years. Preserving this cherished bond and delivering populations - urban and rural - from untold suffering and financial cost, must be a priority for governments wherever rabies holds sway.

Most of us don't actually think about the cost of rabies as we go about our daily routine. After all, the disease is totally preventable and a person can be saved from dying even after an infected animal has bitten him. Right? Wrong.

Besides being the deadliest disease known to mankind, rabies also costs the world billions of dollars every year. A new study estimates the global impact of dog rabies - the source of over 95% of all human rabies cases - alone at over $124 billion dollars annually.

Compare this to the 6 to 8 billion dollars that it would cost to vaccinate the world's dogs, thus eliminating the threat to humans. That equates to a return on investment of between 15 and 20 dollars for every dollar spent. Why would the world's health agencies and governments not jump at this chance to save money and lives?

Well, one of the reasons is knowledge. The cost of rabies, until now, has never really been accurately assessed. Most human cases occur in poor, remote regions where healthcare provision is minimal, and reporting even more so, plus awareness among the general population almost non-existent. And because most cases tend to be isolated, the statisticians tend to miss the bigger picture worldwide, which is that one person dies every eight minutes.

To give an example, a physician friend told me of a hospital in one Asian country which, last week, reported the admission of a 46-year old school clerk. He was admitted with the classic symptoms of rabies having been bitten by a dog four weeks ago but had not known to seek medical care. Worse, his wife reported that the same dog had gone on to bite several children and no one knew what had happened to them. It is too late for this man to be given prophylaxis and as a result the only option for doctors now is to give him 'comfort care'.

At the Global Alliance for Rabies Control, we're determined to bring rabies control up the political agenda in those countries where it hits hardest. Last week at the annual Americas meeting in Toronto, we supported the presentation of a new study examining the actual cost of dog transmitted human rabies which was given by Dr Stephanie Shwiff, a Research Economist, and her team in Ft Collins Colorado and Dr Katie Hampson, a statistical modeler at the University of Glasgow

If we can persuade the politicians to get behind these numbers and invest in what must be one of the easiest wins in public health, we can make a difference. We have the tools necessary to eliminate rabies transmission in dogs and to prevent rabies in humans and we know how to do it. We also have excellent examples of successful and sustainable programs that prove by eliminating rabies in dogs, human rabies cases caused by exposure to rabid dogs will disappear.

In many ways, rabies takes advantage of the special relationship between man and dog. The two species have lived in close quarters and relied on each other for protection, food and companionship for thousands of years. Preserving this cherished bond and delivering populations - urban and rural - from untold suffering and financial cost, must be a priority for governments wherever rabies holds sway.

The author is Executive Director at the Global Alliance for Rabies Control

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