Rabies control in Nepal - Dog Sterilization and Vaccination Program at IAAS

Establishing a student centered, community-based spay/neuter program at IAAS Veterinary School to teach surgical sterilization while controlling rabies in the stray dog population of Chitwan District.

Principal Investigator: Gretchen Kaufman

Project Partners:

• Tribhuvan University Institute for Agriculture and Animal Science
• Nepal's National Zoonoses and Food Hygiene Research Centre

Nepal is a small, landlocked country situated between India and Tibet, with a human population of approximately 27 million. Nepal has one of the highest reported per capita rates of human rabies deaths in the world. As is the case with many other developing countries, the persistence of this disease is centered on domestic dogs as the primary disease reservoir. Rabies is just one of many serious public health problems in Nepal. It provokes great public concern since most Nepalis readily identify this disease with a painful and prolonged death without options for successful treatment once clinical signs appear. However, while clinical infection is untreatable, rabies is a preventable disease. In Nepal, the rabies problem is perpetuated by several factors, including the lack of routine vaccination among pet dogs and the existence of a large unvaccinated stray dog population. Nepalese health professionals have been calling for the development of a national rabies control program since the early 1980s, but have been unable to institute an effective plan to control this disease.

The International faculty at the Tufts Center for Conservation Medicine recognized that gaining control of rabies in developing countries requires a veterinary solution to a serious human health problem. To better examine the problem in Nepal, we organized a workshop in April 2001 in Kathmandu, bringing together animal and human public health professionals, and key governmental and non-governmental organizations interested in or already invested in this problem. The output from that workshop was a concept for a 'Nepal National Rabies Control Program', developed by Tufts Cummings School of Veterinary Medicine’s International Program, Tribhuvan University's Institute for Agricultural and Animal Sciences (IAAS) Veterinary School, and Nepal's National Zoonoses and Food Hygiene Research Centre (NZFHRC), with the support of the Humane Society International (HSI). The concept outlined pragmatic approach to gaining control of rabies in Nepal over a ten-year period, with the long-term objective being the development of a sustainable model for rabies control that can be transferred to other developing countries. The main principles of this plan included research, surveillance, community education, dog registration/vaccination and a humane dog population control program. Concurrent quality sustainable vaccine accessibility and improved capacity for diagnostic testing were also identified in this plan. Over time, incremental steps have been taken that support the key tenets laid out in the concept paper.

Since March 2002, Tufts efforts have been focused on developing the capacity for dog sterilization and rabies vaccination at our partner institution, IAAS, in Chitwan, Nepal. These efforts are supported by the Elinor Patterson Baker Trust, Humane Society International, and are carried out in collaboration with several Nepal based organizations. This program is focused on two major objectives: developing a model of rabies intervention in Chitwan district, and building national veterinary capacity through training Nepal’s future veterinarians in dog sterilization and rabies education at the national veterinary school (IAAS). Veterinary students participate in a community based education program that encourages the practice of dog sterilization and promotes the benefits of regular vaccination. Tufts surgeons have conducted faculty and student training sessions on techniques of dog sterilization, and have helped them to successfully incorporate these techniques as part of their standard surgical curriculum for all veterinary students at IAAS. We are working together to develop a self-sustaining veterinary student centered dog sterilization and vaccination clinic at the IAAS that will continue to provide training for future Nepali veterinarians and encourage them to promote this practice in their communities after graduation.

Through Tufts’ targeted efforts we have begun to increase the capacity of Nepal to gain control over its dog population and this devastating disease. IAAS graduates are beginning to practice surgery in their communities and encourage rabies prevention. They are working with other organizations such as Kathmandu Animal Treatment Center and the HICAST veterinary school in Kathmandu, using their skills to promote our shared goals of humane dog population control and improved canine health. As the dog population becomes better managed, our investigations will focus on potential native wildlife reservoirs. Other objectives of the national plan will be addressed in time through coordinated efforts by other agencies in the public health sector.

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