Back to search

GLOBVAC-Global helse- og vaksin.forskn

Improving implementation and operation of a One Health platform to combat rabies in Malawi

Alternative title: Én Helse-tilnærming for mer effektiv gjennomføring av rabieskontroll i Malawi

Awarded: NOK 12.0 mill.

Dog-mediated rabies in humans is a completely preventable, deadly disease that disproportionately affects rural communities, particularly children, of economically disadvantaged areas of the world. It is not lack of science that stands in the way of successful rabies control, it is the failure to implement well-defined control measures across responsible sectors in areas where rabies is a problem. A rabies control program must at least secure public awareness, disease surveillance, laboratory diagnostics, dog vaccinations and post exposure prophylaxis (PEP) for humans. In this project, led by the Norwegian Veterinary Institute (NVI), a multidisciplinary team of partners from Norway, Malawi and the UK will use an implementation research approach to improve control of rabies in Malawi, a country particularly affected by rabies. Collaborating partners include the NVI, the Public Health Institute of Malawi, the Central Veterinary Laboratory of Malawi, the Norwegian Institute of Public health, the Universities of Bergen, Glasgow and Edinburgh and the non-governmental organization Mission Rabies. The project seeks to improve control of rabies and inform best practice for Malawi and other countries by finding out how One Health can be operationalized to attain a far-reaching impact on our ability to combat zoonotic diseases. A One Health approach bridging scientific disciplines, sectors and civil society actors will be utilized to investigate what interventions are most likely to successfully secure effective rabies control in Malawi, and whether it can be bolstered with social accountability initiatives. We will also assess vaccine-induced immunity in free-roaming dogs and test whether a novel vaccine adjuvant, can improve and prolong immunity in dogs. Finally, by investigating the epidemiology of rabies virus in Malawi the project can inform design of dog vaccine campaigns. Three PhD students in Malawi have mapped and evaluated how surveillance and control of rabies is working in Malawi both in public health and veterinary sectors, as well as how civil society is supporting this work. Preliminary results show that the surveillance of rabies lacks formal structure, and that poor resources is a major bottleneck. A large vaccination campaign for dogs was performed in one district in 2023. In this campaign, the project group and Mission Rabies worked closely with local government structures to implement the campaign, and find out how vaccination campaigns can best be implemented in Malawi. The vaccine trial to evaluate whether addition of a novel adjuvant may boost and prolong immune response in dogs is undereway and results will be available in 2024.

Dog-mediated rabies in humans is a completely preventable, deadly disease that continues to disproportionately affect rural communities, particularly children, of economically disadvantaged areas of the world. It is a neglected zoonotic disease for which increased global action is needed for the sake of health equity. The WHO aims to eliminate dog-mediated rabies in humans by 2030. It is not lack of science that stands in the way of successful control of rabies, it is the failure to implement well-defined measures in the realm of One Health to control disease in endemic areas. Therefore, this project will use an implementation research approach to improve control of rabies in Malawi, a country particularly affected by rabies. The project will save lives, reduce disease burden from rabies and improve health equity also beyond Malawi and Africa. A multi-approach strategy bridging scientific disciplines, sectors and civil society actors will be used to operationalize One Health to combat rabies in Malawi. A rabies control program must secure public awareness, disease surveillance, diagnostics, dog vaccinations and post exposure prophylaxis (PEP) for humans. We will investigate what interventions are most likely to successfully secure implementation of effective rabies control in Malawi and whether it can be bolstered with social accountability initiatives. In addition, we will assess vaccine induced immunity in free-roaming dogs and molecular epidemiology of rabies virus in Malawi to inform design of dog vaccine campaigns. A novel adjuvant will be tested to see if vaccine immunity in dogs can be boosted. Results will improve control of zoonotic diseases in Malawi, enable up scale-up of rabies control and also inform best practice in other countries. By anchoring rabies control in One Health, the project answers to a knowledge need on how One health can best be operationalized, which can have a far-reaching impact on our ability to combat zoonotic diseases.

Funding scheme:

GLOBVAC-Global helse- og vaksin.forskn