Rabies Prevention and Control Program in Bhutan: Self-assessment using SARE Tool

Abstract

Free-roaming dogs and dog bites are a common public health problem in Bhutan. Several control measures were implemented during 1980s including mass killing of dogs by shooting and poisoning. Other control measures such as ad-hoc sterilization and vaccination against rabies, translocation and impounding of dogs were also implemented to reduce dog population and control rabies in the country. From 2009, catch-neuter-vaccinate-release program was initiated to manage dog population and control rabies in the country. Currently rabies outbreaks in animals are commonly reported in southern parts of the country with sporadic incursion into interior rabies free areas. However, no human rabies deaths were reported since 2017. The country is on track to achieve its target to eliminate dog-mediated human rabies deaths by 2030 through One health approach. In this study, we reviewed rabies situation in Bhutan in terms of past and current control measures, gaps and future needs for rabies control using a “Stepwise Approach towards Rabies Elimination [SARE] tool”. We highlighted the areas where more attention is required in order to eliminate rabies in Bhutan. The SARE output was used to develop a “Strategic plan for elimination of dog-mediated rabies in Bhutan by 2023” by incorporating all the agreed activities of Global framework for the elimination of dog-mediated human rabies.