Nel L H
Rev Sci Tech. 2018 Aug;37(2):751-759. doi: 10.20506/rst.37.2.2838.
Rabies control worldwide has been inadequate and neglected for many decades, and the disease continues to predominantly affect poor communities in Africa and Asia. As a zoonosis for which the main reservoir and vector, the domestic dog (Canis familiaris), is an economically non-viable species, the absence of cross-sectoral cooperation has been a major factor in the lack of effective control efforts. A shift in global focus is required to concentrate on the fact that rabies has the highest case fatality ratio of all infectious human diseases and that it still affects human health more significantly than many other infectious diseases that are perceived to pose more significant risks. Equally necessary is an acknowledgement that rabies control is complex and that the task of creating and executing a strategic plan for the disease can be overwhelming for those governments in the developing world where dog rabies is most problematic. Nonprofit organisations operate independently of governments and intergovernmental organisations and can play a dynamic role in inter-sectoral collaboration and the creation of approaches and strategies for the control of complex diseases such as rabies. In 2008, the Global Alliance for Rabies Control (GARC) established Partners for Rabies Prevention (PRP), a widely representative group of rabies stakeholders and experts, which endeavours to support public-private rabies control activities throughout the world. After a landscape analysis, the PRP proceeded to develop and launch the Blueprint for Rabies Prevention and Control (comprising the Blueprint for Canine Rabies Prevention and Control; the Blueprint for Fox Rabies Prevention and Control and the Rabies Surveillance Blueprint). Subsequently, the Stepwise Approach towards Rabies Elimination (SARE) was embedded into the Canine Rabies Blueprint. The SARE is a planning and self-assessment tool that countries can use to develop activities and monitor progress towards a national programme and strategy for sustainable rabies control and elimination. Each of the elements needed to execute the SARE-derived strategy is cross-linked to the Canine Rabies Blueprint, which provides the specific methods and tools required, supported by references and examples. Together, the Canine Rabies Blueprint and the SARE should be regarded as a novel and dynamic operational toolkit, and a resource that provides comprehensive information for the development and implementation of rabies control strategies, built entirely on the principles of 'One Health'.
几十年来,全球范围内的狂犬病防控工作一直不足且被忽视,这种疾病仍然主要影响着非洲和亚洲的贫困社区。作为一种人畜共患病,其主要宿主和传播媒介——家犬(犬属)在经济上是无生存价值的物种,缺乏跨部门合作一直是有效防控工作缺失的主要因素。全球需要转变关注重点,要认识到狂犬病在所有人类传染病中的病死率最高,而且与许多被认为构成更大风险的其他传染病相比,它对人类健康的影响仍然更为显著。同样必要的是,要承认狂犬病防控工作很复杂,对于家犬狂犬病问题最为严重的发展中国家政府而言,制定和执行针对该疾病的战略计划任务可能是艰巨的。非营利组织独立于政府和政府间组织开展运作,在跨部门合作以及为控制狂犬病等复杂疾病制定方法和战略方面可以发挥积极作用。2008年,全球狂犬病控制联盟(GARC)成立了狂犬病预防合作伙伴组织(PRP),这是一个由狂犬病利益相关者和专家组成的具有广泛代表性的团体,致力于支持全球范围内的公私合作狂犬病防控活动。在进行了全面分析之后,PRP着手制定并推出了《狂犬病预防与控制蓝图》(包括《犬类狂犬病预防与控制蓝图》《狐狸狂犬病预防与控制蓝图》以及《狂犬病监测蓝图》)。随后,逐步消除狂犬病方法(SARE)被纳入《犬类狂犬病蓝图》。SARE是一种规划和自我评估工具,各国可利用它来开展活动并监测在制定国家可持续狂犬病控制和消除计划及战略方面的进展。执行源自SARE的战略所需的每个要素都与《犬类狂犬病蓝图》相互关联,该蓝图提供了所需的具体方法和工具,并辅以参考文献和实例。《犬类狂犬病蓝图》和SARE应共同被视为一种新颖且动态的操作工具包,以及一种为狂犬病控制战略的制定和实施提供全面信息的资源,它完全基于“同一健康”原则构建。