Editorial feature: How to eradicate canine rabies in 10 years or less

From ANIMAL PEOPLE, September 2007:

 
“Rabies could be gone in a decade,” BBC
News headlined worldwide on September 8, 2007.
“Rabies could be wiped out across the world,”
the BBC report continued, “if sufficient
vaccinations are carried out on domestic dogs,
according to experts.”
BBC News went on to quote staff of the
Royal Dick Veterinary School at Edinburgh
University in Scotland, who were among the
cofounders of the Alliance for Rabies Control and
promoters of the first World Rabies Day, held on
September 7, 2007.
None of the Alliance for Rabies Control
spokespersons appear to have actually set any
sort of timetable for possibly eradicating
rabies, but no matter. Experts have recognized
for decades that rabies is wholly eradicable from
all species except bats through targeted mass
immunization–and the chief obstacle to
eradicating bat rabies is that no one has
developed an aerosolized vaccine that could be
sprayed into otherwise inaccessible caves and
tree trunks. Inventing such a vaccine is
considered difficult but possible.

U.S. Centers for Disease Control rabies
program chief Charles Rupprecht on World Rabies
Day formally pronounced the U.S. free of canine
rabies, but similar informal proclamations have
been issued for years.
“The tools for effective rabies control
are available. What is lacking is the
motivation, commitment and resources to tackle
the disease effectively,” the Alliance for
Rabies Control declared. “Mass vaccination of
the domestic dog provides the most cost-effective
and efficient strategy for controlling canine
rabies and hence transmission from dogs to
humans,” the Alliance elaborated. “Lacking are
the delivery systems, public education campaigns
and resources to apply these technologies in the
developing world.”
Asserting that rabies kills 100 children
per day, worldwide, the Alliance for Rabies
Control acknowledged that “Rabies is also a
concern for animal welfare, as fear of the
disease results in hostile and antagonistic
attitudes towards dogs and often inhumane
approaches to dealing with suspected rabid dogs
by communities.”
The Alliance for Rabies Control
emphasizes the need to expand dog vaccination
against rabies in Asia and Africa.
“In Asia and Africa,” the Alliance for
Rabies Control points out, “the domestic dog is
the main reservoir for rabies. As rabies is
generally maintained only in a single reservoir
population in any given area, control of disease
in this population will result in its
disappearance from all other species. This has
been demonstrated with the elimination of rabies
following oral vaccination of foxes in western
Europe, where red foxes are the reservoir host.
Results from research projects in eastern Africa
show that mass vaccination of domestic dogs has
the same result, even in areas such as the
Serengeti ecosystem, which comprise a wide
diversity of wildlife species. When sufficient
domestic dogs are vaccinated, rabies also
declines in wildlife, and human exposures to the
rabies virus are significantly reduced.”
“In areas where there is a high
prevalence of rabies, such as Africa and Asia, ”
the Alliance for Rabies Control added, “the need
for vaccination has often been overlooked,
despite the fact this would cost less than other
health care programs,” including administering
post-exposure rabies immunization to save dog
bite victims.
The Alliance for Rabies Control strongly
favors post-exposure immunization, as well as
prophylactic vaccination, but points out that
post-exposure immunization is not a rabies
suppression strategy, because it does not
neutralize the host reservoir.
Subsidized post-exposure vaccination is
the standard response to rabies in India, China,
and much of Africa. Post-exposure vaccination
saves thousands of lives annually, despite
many failures when dog bite victims fail to seek
treatment soon enough, do not complete the full
course of injections, or receive fake, expired,
or obsolescent vaccines, a problem particularly
prevalent in parts of India and China, where
post-exposure vaccines are often made by local
suppliers, using formulas elsewhere long
abandoned.
While post-exposure vaccination is
essential, and should continue, with
improvement to achieve consistently positive
results, progress toward eliminating rabies has
been markedly faster in nations that have
emphasized preventively vaccinating dogs.
Argentinian medical doctor Oscar Larghi
demonstrated during the mid-1990s, for example,
that inexpensive three-month dog vaccination
drives could succeed in even the largest and
poorest shanty-towns. Larghi also demonstrated
that while reducing the street dog population may
be of some value in reducing the numbers of dogs
to be vaccinated, dog population reduction is
not otherwise a significant or essential part of
an effective rabies control strategy.
Reported Larghi to the members of the
International Society for Infectious Diseases in
May 1998, “Control of rabies in developing
countries can be very successful if based on
appropriate planning, health education of human
populations, 70% vaccine coverage of dog
populations, and epidemiological surveillance.
These parameters, with little emphasis in dog
population reduction (less than 10% of the
estimated population), were applied in the
metropolitan area of Buenos Aires, Argentina
(10.5 million inhabitants), Lima-Callao, Peru
(6.5 million inhabitants), and Sao Paulo, Brazil
(14 million inhabitants). Dog rabies cases were
reduced to zero, from close to 5,000 cases per
year in Buenos Aires, 1,000 in Lima, and 1,200
in Sao Paulo.”
In each city, the rabies control teams
impounded and euthanized only dogs who appeared
to be already rabid, aggressive, or otherwise
severely unhealthy.
The preventive vaccination approach also
works in wildlife. Anne Arundel County,
Maryland, for example, had 97 cases of animal
rabies in 1997, when county officials began
experimentally distributing oral rabies vaccine
pellets to immunize raccoons. Gradually
expanding the program, the county had just 10
animal rabies cases in 2006.
An attempt begun a year earlier to
eradicate coyote rabies in Texas, by
air-dropping vaccine bait pellets, achieved a
98% reduction of canine rabies in all species by
1998.
As long ago as 1973, William Winkler,
M.D., of the U.S. Centers for Disease Control
and Prevention, warned in the National Academy
of Sciences’ handbook Control of Rabies, that
“Persistent trapping or poisoning campaigns as a
means to rabies control should be abolished.
There is no evidence,” Winkler wrote, “that
these costly and politically attractive programs
reduce either wildlife reservoirs or rabies
incidence.” Similar language has appeared ever
since in the Compendium of Animal Rabies
Prevention & Control, an annual publication of
the National Association of State Public Health
Veterinarians.
Good examples and bad
Agriculture and Rural Development
director Ferreira da Conceição of Lunada
province, Angola, took the necessary approach
in August 2007, directing a three-week drive
that vaccinated 63,544 dogs, cats, monkeys,
livestock, and work animals.
But a more discouraging example emerged
in Addis Ababa, the national capital of
Ethiopia, just a month after the Homeless Animal
Protection Society of Ethiopia seemed to be
making headway toward establishing a high-volume
dog sterilization and vaccination program after
seven years of struggle. As with other
sterilization and vaccination programs around the
world, the vaccination component would be the
essential element in rabies preventation.
Sterilization would stabilize the dog population
to prevent the other complaints about dogs’
presence and behavior that so often causes public
officials to seize upon even the vaguest hint of
a rabies outbreak as an excuse to kill dogs.
As the July/August 2007 edition of ANIMAL
PEOPLE recounted, HAPS in June 2007 rescued four
street dogs from a 70-year-old gun emplacement
where they had been dumped to die, British
songwriter Maria Daines’ recording One Small Dog,
written in appreciation of the rescue and titled
in honor of the bravest dog, on August 2, 2007
reached the #1 position on the Soundclick pop
rock chart.
Daines donated all proceedings from her
surprise hit to HAPS, but HAPS cofounders Hana
Kifle and Efrem Legese had little to celebrate.
HAPS had won a contract from the Addis
Ababa government to sterilize and vaccinate
street dogs. The contract enabled them to
operate a clinic, but the contract was unfunded.
As a little-known charity in a remote location,
HAPS had difficulty attracting the support
required to treat the half million dogs in Addis
Ababa who must be sterilized and vaccinated to
reach the 70% target necessary to stabilize the
dog population and prevent rabies from spreading
among them.
Revoking the contract, and HAPS’
authorization to run the clinic, Addis Ababa
officials announced that they would use
strychnine to poison as many dogs as possible to
try to eradicate rabies before the mid-September
celebration of the Coptic millennium.
Thereby, the officials demonstrated that
they had learned little more about rabies
control, animal population management, and
urban sanitation than might have been known to
the Queen of Sheba, who reputedly lived near
Addis Ababa about 3,000 years ago.
Poisoning street dogs had already been
introduced as long as 2,000 years earlier in
Egypt-and poisoning campaigns that caused dog
populations to briefly crash might have
contributed to the conditions that drew African
desert cats into Egyptian cities to hunt rats and
mice. Those cats became the progenitors of
today’s domestic house cats and feral cats.
Under pressure of medieval cat purges, domestic
and feral cats approximately quadrupled their
fecundity: the mummified remains of early
Egyptian cats reveal that they had only two
kittens per litter and one litter per year, like
African desert cats, but modern house cats and
feral cats often have litters of four or more
kittens, and raise two litters per year if
conditions permit.
Public policymakers have pursued backward
and self-defeating animal control strategies
since the dawn of civilization because the logic
of exterminating animals who are perceived as
nuisances appears inescapable: kill them and
they will be no more. Dead animals do not
reproduce, the policymakers reason. Neither do
dead animals transmit deadly diseases, like
rabies, which can only be spread through live
hosts.
Yet life had already evolved a
counter-strategy many hundreds of millions of
years before humans existed. All species, from
the rabies virus to blue whales, reproduce up to
the carrying capacity of their habitat, as
rapidly as possible. If one species succumbs to
disease, disaster, or predation so rapidly that
it cannot fill the habitat, another species
moves in. Never does nature allow habitat to go
unoccupied.
Until the carrying capacity of cities for
free-roaming mid-sized predators and scavengers
is permanently reduced by instituting effective
sanitation, campaigns to exterminate street
dogs, feral cats, or any other established
resident species merely exchanges those animals
for others. Killing dogs and cats not only
removes a major check on the growth of the rat
and mouse population, for instance, but invites
in more problematic species to take their places.
Many Asian cities now have
hard-to-control populations of feral pigs,
macaques, and even jackals, leopards, and
cobras in their suburbs, in consequence of
rapidly reducing dog populations through
sterilization in the more enlightened
communities, and elsewhere through the combined
effects of extermination and great increases in
motor vehicle traffic.
Policymakers in the developing world
often seek for their cities the superficially
animal-free appearance of a “modern” city that
they see in Europe and the U.S., equating this
with ridding themselves of rabies. But casual
outdoor observation of European and U.S. cities
by daylight is deeply deceptive. European and
American cities support even more dogs, cats,
and wild animals per thousand humans than the
cities of the developing world. They have merely
achieved a transition from hosting outdoor
animals, seen in daytime, to hosting mostly
indoor pets and nocturnal wildlife.
Motor vehicles, rather than any animal
control strategies, appear to be the major
transitionary agents. Motor vehicle traffic
reduces street dog populations by killing dogs,
obviously enough, but this is the least of the
vehicular impacts, and is no different in effect
from animal control killing. Busy streets also
isolate dogs from each other, inhibiting
reproduction. Most important, replacing urban
grain storage for work animals with gasoline
stations steeply reduces the numbers of rats
accessible to dogs. Replacing work animals with
cars and trucks also eliminates animal droppings
from the streets, an important “filler” food for
street dogs.
As street dogs disappear, ceding
scavenging roles to raccoons and opossums in the
U.S., and pigs and monkeys in much of the rest
of the world, feral cats proliferate.
The same factors affect the cat
population, but cats are smaller, so are better
able to survive on the remaining food sources,
without canine competition. Cats are also better
able to prey upon mice and rats who live indoors,
and cats are able to spend their days away from
traffic on rooftops or in crawl spaces, hunting
by night.
If feral cat populations steeply
diminish, as has occurred in the U.S. and
Britain during the past 15-20 years through the
introduction of feral cat sterilization programs,
the habitat niches that the cats formerly filled
are taken over by urbanized wild predators
including coyotes, foxes, fishers, bobcats,
hawks, owls, and eagles.
But neither dogs nor cats actually
decline in numbers, as illustrated by comparing
data collected by pioneering dog and cat
population ecologist John Marbanks in 1947-1950,
when canine rabies still raged in the U.S., to
the findings of more recent studies.
Sixty years ago, just after World War
II, the mechanization of transportation and
establishment of urban sanitation were about as
advanced in the U.S. as they are today in
Ethiopia, India, and much of the rest of Africa
and Asia, as well as Latin America. Not
surprisingly, Marbanks found that about 30% of
the U.S. dog population were what we would now
term street dogs, and about 30 million cats were
what we would now term feral, a situation
comparable to what we now see in the developing
world.
Marbanks estimated that there were only
600,000 street dogs in the already heavily
motorized Northeast, but were 3.5 million in the
South and 2.3 million in the Midwest, the two
most agrarian parts of the U.S.
More than 20 years passed before the U.S.
dog and cat populations were again studied in
depth. By then, in the early 1970s, the U.S.
street dog population had disappeared. The feral
cat population rose in the absence of street dogs
to a peak of about 40 million circa 1990, then
fell with the advent of neuter/return to today’s
levels of about six million in winter, 12
million in summer.
In the interim, the number of cars and
miles driven in the U.S. had tripled. The pet
dog and cat populations rose proportionate to the
human population. The pet dog population
increased by just about exactly as much as the
street dog population declined. The biomass of
dogs and cats relative to human population
remained almost the same.
Canine rabies was already close to
elimination, but not because there were fewer
dogs. Rather, canine rabies had nearly
disappeared because unvaccinated street dogs had
been replaced by an almost equal number of
vaccinated pets.

Carrying capacity

In effect, mechanization of transport
and improvements in urban sanitation reallocated
the carrying capacity of the human environment.
Instead of supporting dogs and cats who lived
directly off of refuse and rodents, the human
environment evolved to support dogs and cats who
lived on refuse that was processed into pet food,
fed to them in human homes.
This same reallocation of carrying
capacity has occurred in western Europe, and is
occurring now in eastern Europe, India, China,
Ethiopia, and wherever else economic development
is transforming former hubs of agrarian commerce
into technologically developed modern cities.
Paving streets tends to eliminate feral
pigs, since pigs need mud to wallow in. That
tends to leave more habitat to monkeys, if
free-roaming dogs disappear-mostly macaques in
Asia, baboons in Africa. Macaques and baboons
do not run from feral cats, bite more often and
more dangerously than dogs, are capable of
transmitting more deadly diseases to humans than
any other animals even though they rarely carry
rabies, can outclimb cats, and are often
smarter than the public policymakers whose
misguided ideas about animal control invite their
presence.
Completely eliminating rabies from Addis
Ababa and other major cities in the developing
world would be a big job, but Larghi’s
vaccination efforts in Latin America were bigger
still. Such a program in Addis Ababa would
appear to have public support, as the plan to
poison dogs was not well-accepted, even among
Muslims who told reporters-wrongly-that the
Prophet Mohammed forbade keeping dogs as pets.
“Dogicide is an act that should be
condemned in the strongest words possible,”
wrote Kassahun Addis of the Sub-Saharan Informer
weekly newspaper.
Similar defenses of dogs have emerged
around the world in recent years wherever dog
purges have been waged or even rumored–even in
nations with long histories of repressing dissent.
Ahead is the urgent task of educating
policymakers about urban ecology and more humane
and effective methods of animal control, of
which rabies control is part.
Equally important is educating
policymakers about how to successfully enlist the
support of pro-animal donors and foundations.
Governments have been handing off
responsibility for animal control to humane
societies by making heavy-handed threats to kill
animals by cruel means for 130 years now,
beginning in 1877 when the Women’s Humane Society
of Philadelphia took over the Philadelphia pound
to halt the practices of clubbing and drowning
dogs and cats.
Of note is that the response of the U.S.
humane community included significant wrong
turns, which actually delayed the eradication of
canine rabies by decades.
American SPCA founder Henry Bergh
resisted pressure to take over the New York City
pounds, accurately perceiving that the job would
sap the ability of the ASPCA to do effective
anti-cruelty advocacy, but seven years after
Bergh’s death the ASPCA did assume the pound job
and held it for the next 100 years, killing more
than a quarter of a million dogs and cats per
year in the 1960s, mostly by gas.
Humane societies increasingly felt
themselves compelled to take responsibility for
animal control sheltering after policymakers
discovered the persuasive effect of selling
animals to laboratories. The American Humane
Association, as the only national humane society
in the U.S. before the mid-20th century,
responded by urging humane societies to take
animal control contracts–and to boycott
compulsory rabies vaccination, as vaccine
development and production were perceived as
unacceptably cruel to laboratory animals and the
sheep whose brains were used to make the early
rabies vaccines. (The sheep brain vaccines were
long ago replaced in most of the world by
vaccines cultivated in hens’ eggs.)
For much of the 20th century the chief
occupation of U.S. humane societies was killing
dogs and cats by the multi-million, in the names
of rabies control and population control, while
the moral vision and momentum of the early humane
movement slumped into despairing self-isolation.
The brightest outlook for the future offered by
1963 humane movement historian William Alan
Swallow was not that either rabies or pet
overpopulation could be contained, but rather
that humane societies might take over the pet
cemetery business.
As the numbers of impounded dogs and cats
only increased, with no money available to
subsidize and promote sterilization, many humane
societies resorted to killing methods, such as
mass gassing and decompression, that were not
much less cruel, if at all, than the methods of
the private animal control contractors they had
replaced.
The lowest point may have come when
then-nationally prominent anti-vivisection
evangelist Ann Brandt, now long forgotten, was
arrested in the act of drowning cats in a barrel.
Much of the U.S. humane community is now
out of the high-volume animal killing business,
albeit seldom easily and often with considerable
misgivings about returning animal control duties
to municipal management.
Yet the humane community has learned that
while donors will not generously support
organizations known for killing animals, they do
contribute far beyond anyone’s anticipation 30
years ago to prevent killing through
sterilization and vaccination. Among the
best-known examples are the ninefold increase in
donations experienced by the San Francisco SPCA
in the decade after it went no-kill in 1984, and
the explosive growth of the no-kill Best Friends
Animal Society from marginal viability in 1990
into one of the largest and still fastest-growing
humane organizations in the world.
Since the early 1970s, sterilization
programs subsidized by pro-animal donors have
helped to cut the numbers of dogs and cats killed
in U.S. shelters and pounds from 115 per 1,000
Americans to 12.5.
Belated humane support of vaccination
meanwhile reduced canine rabies to the verge of
extirpation within a decade of the late start,
and completed the eradication with intensive
efforts wherever cases appeared thereafter.
Now the developing world needs to learn
from the U.S. experience–and, most critically,
needs to avoid repeating the U.S. mistakes.

Building success

This is not an argument that humane
societies should stay altogether out of doing
animal control work.
Indeed, humane societies have vital
roles in doing the job effectively and kindly.
The many highly effective Animal Birth Control
programs operated by humane societies in India
offer models for the world, along with similar
programs in Turkey, Thailand, Indonesia, and
parts of eastern Europe. While many of these
programs can be improved, they are clearly
making progress in the right direction.
Humane societies should avoid assuming
financial responsibility for impounding
potentially infinite numbers of animals, which
often leads to operating death camps. However,
humane societies are much better positioned than
public agencies, especially in the developing
world, to offer sterilization, vaccination,
and other lifesaving services, and to do public
education.
The critical lesson to impart to
policymakers is that extortion does not raise the
resources that the humane community needs to do
the work it can do best. Neither does impatience
help small charities to grow into doing big jobs.
Few if any humane societies in the
developing world (or anywhere) have built
sterilization programs faster than Animal Help,
of Ahmedabad, India, but Animal Help built
capacity for six years before it sterilized and
vaccinated 50,000 dogs in 2006. Founder Rahul
Sehgal frankly acknowledges that the time and
practice was essential to subsequent success.
If the municipal officials of Addis Ababa
want HAPS to help them purge the city of rabies
and a perceived over-abundance of street dogs,
they must help HAPS to build capacity and
demonstrate, step by step, the potential for
further growth.
Even more important, the municipal
officials of Addis Ababa-and every other city
threatening to kill animals if humane donors do
not intervene-must understand that donors will
not contribute money if they fear that all the
animals will be killed no matter what. Humane
donors are continually asked to support
worthwhile projects, in all parts of the world.
Deciding which are most worthy of support, most
donors will choose the programs that they
perceive are most likely to achieve happy
endings.
Programs under stress from unsympathetic
governments tend to look like bad bets, no
matter what their achievements, as the Bangalore
humane societies Compassion Unlimited Plus
Action, the Animal Rights Fund, Krupa, and
Karuna can testify.
The four charities’ internationally
recognized ABC programs, cited as positive
examples by World Health Organization chief F.X.
Meslin, had eliminated rabies from their service
areas and had brought the dog population down
markedly before 2007.
This year, however, Bangalore city
officials wrongly blamed the ABC programs for two
fatal dog attacks, which occurred chiefly
because the city government failed to stop
butchers in areas outside the ABC program limits
from dumping meat wastes in vacant lots–despite
repeated warnings from the Animal Rights Fund.
The officials’ attacks obliged the
Bangalore humane societies to suspend their ABC
work, and severely harmed their ability to raise
funds to resume. Poor administration of the
Bangalore municipal animal control program
meanwhile allowed rabies to re-infiltrate the
city.
Success builds on success. Successful
humane societies can eradicate canine rabies
worldwide and help communities in even the
poorest, most remote places to achieve humane
animal population control-but only when
policymakers properly understand and contribute
to the necessary preconditions.