Findings from the initial Stepwise Approach to Rabies Elimination (SARE) Assessment in China, 2019

Abstract

In 2015, China and other member states of the United Nations adopted the goal of eliminating dog-mediated rabies by 2030. China has made substantial progress in reducing dog-mediated human rabies since peaking with more than 3,300 reported cases in 2007. To further improve coordination and planning, the Chinese Center for Disease Control and Prevention, in collaboration with the United States Centers for Disease Control and Prevention, conducted a Stepwise Approach towards Rabies Elimination (SARE) assessment in March 2019. Assessment goals included outlining progress and identifying activities critical for eliminating dog-mediated rabies. Participants representing national, provincial and local human and animal health sectors in China used the SARE assessment tool to answer 115 questions about the current dog-mediated rabies control and prevention programs in China. The established surveillance system for human rabies cases and availability of post-exposure prophylaxis were identified as strengths. Low dog vaccination coverage and limited laboratory confirmation of rabid dogs were identified gaps, resulting in an overall score of 1.5 on a scale of 0 to 5. Participants outlined steps to increase cross-sectoral information sharing, improve surveillance for dog rabies, increase dog vaccination coverage, and increase laboratory capacity to diagnose rabies at the provincial level. All assessment participants committed to strengthening cross-sector collaboration using a One Health approach to achieve dog-mediated human rabies elimination by 2030.

Assessing Impacting Factors of Dog Owners’ Adoption of Dog Vaccination Against Rabies: A Cross-sectional Survey in Rural Areas — Guangxi Zhuang Autonomous Region, China, 2021

“…This is related to the reason of keeping dogs for house guarding ( 10 ). This research also found that only about 19.1% of dog-owning households reported having their dogs vaccinated, much lower than the minimum requirement to achieve interruptions in dog-mediated rabies spread ( 1 ) and also lower than that in economically developed regions, such as 85.0%–100.0% in Shanghai ( 10 ), 80.0% in Beijing ( 11 ), and above 70% in the Pearl River Delta region in Guangdong Province ( 4 ). The findings illustrated that there will still be much room for improving rabies control when progress is achieved in the endemic area ( 12 ).…”

“…In 2015, the World Health Organization, the World Organisation for Animal Health, and the Food and Agriculture Organization of the United Nations (FAO) in collaboration with Global Alliance for Rabies Control proposed eliminating dog-mediated rabies globally by 2030 ("zero by 2030"). Although the vaccination coverage among registered dogs is required to meet 90% by the National Animal Rabies Prevention and Control Plan (3), current low vaccination coverage in dogs was the main obstacle for China to eliminate dogtransmitted rabies (4). Therefore, it is important to know the impacting factors associated with low dog vaccination rates in rural areas to design well-targeted rabies control programs.…”

Using a One Health approach to prioritize zoonotic diseases in China, 2019

“…OHZDP workshop participants from other countries made similar recommendations for developing systems or mechanisms to organize and harmonize data collection (including standardization) across the relevant different sectors for the priority zoonoses [32]. Such systems could be implemented at the national and provincial level in China and include feedback tools (e.g., dashboards for visualization) for key decision makers in each sector [33,34]. Animal disease surveillance, including at animal farms, breeding sites, and market locations are critical for early detection of zoonotic diseases and limiting transmission or 'spill-over' to the human population.…”

Human rabies: prospects for elimination

“…Efforts to build capacity and improve collection and reporting of surveillance data include regional and national level training on reliable laboratory methods [42] and the use of electronic surveillance platforms [48]. A few articles report countries' self-assessments using the Stepwise Approach towards Rabies Elimination (SARE) tool [126], for example, Haiti, Kenya, and Liberia have used their SARE score for effective advocacy [117,127]. Despite data limitations, results from these assessments indicate most countries in Africa are in early stages of SARE, whereas some countries in Asia are further progressed [49,126,128].…”