UK (University of Glasgow) Impacts on global health

DRIVING CHANGE AND INVESTMENT IN INTERNATIONAL POLICY ON RABIES POST-EXPOSURE PROPHYLAXIS

Canine rabies is an infectious viral disease that is universally fatal following the onset of clinical symptoms. Despite being wholly preventable through vaccination, it is responsible for up to 59,000 human deaths each year. Rabies post-exposure prophylaxis (PEP)—given to people within 24 hours of being bitten by potentially infected dogs—is a vital tool for reducing rabies deaths worldwide. However, access to this life-saving treatment is restricted by a lack of consensus, and thus investment, on which treatment regimen to use in specific settings.

University of Glasgow research provided epidemiological and cost-effectiveness modelling that substantiated the revised World Health Organization (WHO) policy on rabies PEP regimens, which recommended a 1-week, two-site intradermal injection regimen as the most cost-effective approach. At the same time, University of Glasgow researchers worked with the international vaccines funding consortium (Gavi, the Vaccine Alliance) to model different investment scenarios in rabies PEP, addressing uncertainties on their impact. The streamlined WHO policy, together with the additional modelling for Gavi, was instrumental to the 2018 decision taken by Gavi to add rabies PEP to their 2021–2025 investment strategy, supporting access to this intervention across 57 developing countries. Multiple countries with endemic rabies have now revised, or are in the process of revising, their rabies PEP guidelines to bring them into line with WHO recommendations.