This article is part of HuffPost’s Project Zero campaign, a yearlong series on neglected tropical diseases and efforts to fight them.
Rabies is one of the most lethal viruses known to man. It kills virtually 100 percent of victims who don’t get the vaccine.
Today, there is both the knowledge and the practical means to eradicate the disease, but it still causes 69,000 deaths worldwide every year. That’s 189 people a day.
Rabies is transmitted to humans by the bite of an infected animal, usually a dog. After infection, it typically takes between one and three months for a person to show symptoms. By the time they do, their death is inevitable.
From the onset of symptoms, the end is swift but terrifying. The victim’s brain swells, causing rising anxiety that turns into hallucinations and later full-blown delirium.
In 1885, the French biologist Louis Pasteur administered a dose of an experimental vaccine to a 9-year old boy who’d been mauled by a rabid dog. The boy became the first known human to survive the virus. Pasteur’s vaccine, which contained the dried spinal cord of an infected rabbit, predated any modern understanding of viruses and was very different from the vaccines based on inactivated tissue culture that we use today.
Studies have shown that eliminating rabies would be cost-effective. The disease results in an estimated $8.6 billion of economic losses annually, but eliminating it in Africa could cost just $1 billion, a fifth of what is spent each year on malaria control.
Experiments show that eliminating rabies in humans is also simple. Vaccinate 70 percent of the dog population in areas where rabies is endemic, and the disease disappears. So why have we not done it already?
Rabies almost exclusively kills people in developing countries ― which means it is not a priority disease for the West.
Anyone exposed to the virus has 10 days to get the vaccine, a method known as post-exposure prophylaxis. The vaccine is 100 percent effective, but many people cannot afford it.
A recent study in Kenya found that bite victims paid up to $500 for treatment, nearly half the average per capita income.
India alone, where more than a fifth of the population lives on just $1.25 a day, accounts for 35 percent of rabies deaths worldwide.
Another 36 percent of deaths take place in sub-Saharan Africa, where two-fifths of people live on less than $1.25 per day.
Complicating the issue is the fact that rabies falls between government ministries for animal and human health, according to Felix Lankester, who started his career as a wild animal vet and is now a clinical assistant professor at the Paul G. Allen School for Global Animal Health at Washington State University.
“Health globally has been divided into human health and animal health,” Lankester said, even though 60 to 70 percent of human diseases come from animals.
“Dogs transmit [rabies], so agriculture ministries need to intervene,” he said. “Yet because it’s people that suffer, it’s health ministries that benefit from the reduced cost of the human disease.”
Coordinating a veterinary response to a human health problem is not easy, says Lankester, whose project ― the Serengeti Health Initiative ― oversaw the elimination of canine rabies in Tanzania’s Serengeti, one of the world’s most famous national parks.
The challenge of engaging health ministries in this cross-sector problem is particularly acute where the health systems are already overburdened and underfunded.
Kenya is the first country in Africa to launch a national strategy to be rabies-free by 2030. Tanzania recently developed its own elimination strategy, and other governments on the continent are expected to follow soon.
Lankester calls rabies “the low-hanging fruit of disease control” because it’s both possible and cost-effective to eliminate it. And, as Lankester notes, “it’s the socially just thing to do” ― to free the world’s less developed nations from this horrific disease and make Louis Pasteur’s dream a reality.
This series is supported, in part, by funding from the Bill & Melinda Gates Foundation. All content is editorially independent, with no influence or input from the foundation.
If you’d like to contribute a post to the series, send an email to ProjectZero@huffingtonpost.com. And follow the conversation on social media by using the hashtag #ProjectZero.
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CORRECTION: An earlier version of this story incorrectly stated that rabies kills virtually all patients who don’t get the vaccine within 10 days of exposure. In fact, the vaccine can be effective after that period ― as long as it’s administered before the onset of symptoms.
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