FAO's Support on Integrated Rabies Control in Indonesia_September 23.pptx

FAO and SDGs
FAO and rabies elimination effort
What is ECTAD doing
Lessons from integrated rabies control and elimination in Indonesia
Options to enhance rabies control in the future

1. FAO’s Support on Integrated Rabies Control in Indonesia Jakarta, 20 September 2023 Rabies response team The Emergency Center for Transboundary Animal Diseases, FAO Indonesia

2. FAO and the SDGs FAO and rabies elimination effort What is ECTAD doing in Indonesia? Lessons for integrated rabies control and elimination in Indonesia Options to enhance rabies control in the future Presentation content FAO’s Support on Integrated Rabies Control in Indonesia

3. FAO and the SGDs

4. Rabies has a significant impact on lives and livelihoods in developing countries, kills + 59,000 people per year The poor and marginalized communities are most heavily impacted 4 of 10 deaths of rabies are in children Over 99% rabies in humans are transmitted by dogs’ bite The economic impact of rabies is enormous at USD 8.6 billion annually, 6% of that is due to livestock losses Rabies is fatal, yet it is preventable through vaccination Rabies is a model disease for One Health approach Dog-mediated rabies: facts FAO and rabies elimination effort

5. FAO is partnering with the WHO, OIE, and GARC to form the United Against Rabies (UAR) collaboration that is supporting countries to reach the goal of zero human deaths by 2030 FAO is supporting countries through the development of tools such as the stepwise approach toward rabies elimination (SARE) and capacity development for laboratory and field workers Way forward: a coordinated One Health effort is needed to ensure zero human deaths from dog-mediated rabies by 2030, and FAO, as part of UAR, will continue to collaborate with countries and communities to reach this goal How FAO and key partners are responding FAO and rabies elimination effort

6. Masterplan Nasional Pemberantasan Rabies di Indonesia A technical guidelines for animal health sector One Health Roadmap Eliminasi Rabies Nasional 2030 A technical guidelines for collaborated rabies elimination program in Indonesia Support the development of national guidelines What is FAO ECTAD doing in Indonesia?

7. Support technical capacity buildings What is FAO ECTAD doing in Indonesia? Mass dog vaccination (MDV) Oral rabies vaccination pilot Data management Sample collection Rapid response Integrated bite case management (IBCM)

8. R10 R2 R3 R4 R5 R6 R7 R8 R9 Support dog vaccination program in several provinces Example: annual MDV across the Bali island has been implemented by local government with the support from central government and FAO since 2011 ( https://rabiesalliance.org/resource/faos-technical-cooperation-project-bali )  Additional strategies to increase coverage: sweeping and emergency vaccinations Pilot vaccination in Gianyar Island-wide Vaccination R1 What is FAO ECTAD doing in Indonesia?

9. A-Team story On the front-line of eradicating rabies from Bali and remote rural areas are the vaccination teams, known as the “A-Teams” 1 vaccinator, 1 recorder, 4 dog catchers The teams search villages and remote mountainous areas for roaming dogs  ( https ://www.youtube.com/watch?v=_VBxYMXY0nc&t=73s )  What is FAO ECTAD doing in Indonesia?

10. Support ORV studies in Bali What is FAO ECTAD doing in Indonesia? Background: One of the biggest challenges for rabies elimination is vaccinating free-roaming dogs To address this challenge the option of using ORV is considered Two studies of ORV on the bait acceptance and oral vaccine immunogenicity were implemented in Karangasem and Buleleng , Bali ( https://kumparan.com/kanalbali/uji-coba-vaksin-oral-rabies-dilakukan-kementan-di-bali-1wzIVFtahjl/full ) 

11. ORV studies in Bali: results What is FAO ECTAD doing in Indonesia? The study yielded positive results in terms of improving the quality of MDV in Indonesia for wider national use. L ocal dogs readily accepted both a locally created intestinal bait and an industrially produced egg-flavored bait, with success rates of 83% and 95%, respectively. The immunogenicity: there was no significant quantitative difference in the level of antibodies between orally and parenterally vaccinated dogs under field conditions in Indonesia. Besides , a survey among field officers also indicated that they preferred ORV over CVR, as the former is more suitable for vaccinating inaccessible dogs and less stressful for the teams and the animals.

12. Support dog vaccination data management by developing RVC apps What is FAO ECTAD doing in Indonesia?

13. IBCM was first established in Bali in 2011 Which then, was re-introduced in 2016 following the surge in cases in 2015 ( https://www.fao.org/indonesia/news/detail-events/fr/c/431438/ )  IBCM is a One Health protocol to enhance networking among different sectors (animal-wildlife health and public health) in managing and responding to bite cases Support capacity building on IBCM and its i mplementation What is FAO ECTAD doing in Indonesia?

14. What is FAO ECTAD doing in Indonesia? Results: IBCM improved … Response to bite cases Coordination and communication between sectors Sample submission to animal health laboratories Human case management (efficiency in the use of rabies post-exposure prophylaxis/PEP) Surveillance activities

15. What is FAO ECTAD doing in Indonesia? 2016-19: development of IBCM for three sectors – wildlife implemented in four pilots IBCM is used as a model for One Health control measures for other zoonoses: anthrax, leptospirosis, avian influenza, and EIDs …c ontinued

16. Increase economic efficiency through the expansion of intervention programmes across sectors Economic efficiency can be seen from the results of the evaluation of cross-sectoral cooperation implementation in North Sulawesi province​ The program generates a benefit-cost ratio (BCR) between  6.56 and 14.35 , which means that for every dollar invested, the program can generate benefits worth USD 6.56-14.35. ​ IBCM’s added value… 10   What is FAO ECTAD doing in Indonesia?

17. SIZE is a national health surveillance information system linked information systems from three different sectors (public health, animal health and wildlife/environment ) SIZE aims to support early detection, reporting, and response through coordination, communication and collaboration from field  level to policy decision-makers SIZE on rabies has been piloted in 4 provinces and plan to expand to other provinces  SIZE will be expanded for other priority zoonosis diseases  Support system informasi zoonosis dan EID (SIZE) development Animal Health Public Health Wildlife Health What is FAO ECTAD doing in Indonesia?

18. Support DPM pilot in Bali What is FAO ECTAD doing in Indonesia? DPM program was piloted in Gianyar , Bali ( https://www.fao.org/indonesia/news/detail-events/zh/c/426486/ )  DPM was piloted focusing on community empowerment as a cadre to educate communities and backed up by traditional law enforcement It promotes responsible dog ownership, increases public awareness of rabies risk to the community as well as increases dog vaccination coverage In recent years, the Government have involved community as zoonoses cadres to support zoonoses response and control, particularly rabies

19. Target: Elementary school Communities Culture and religion group What is FAO ECTAD doing in Indonesia? Support public awareness

20. Example: IEC Materials What is FAO ECTAD doing in Indonesia?

21. Support community involvement through Dana D esa What is FAO ECTAD doing in Indonesia? The development of practical guidelines for the prevention and control of zoonoses and EIDs through optimizing the function of Puskeswan with the support of village funds This guide can be used by Puskeswan throughout Indonesia for prevention and control of zoonoses and EIDs, as well as for the development rural economy through livestock and animal health The use of Dana Desa Rabies vaccines procurement Dog vaccination activities Leptospirosis surveillance activities Community capacity building

22. Support community involvement through zoonoses cadre What is FAO ECTAD doing in Indonesia? The development of practical guidelines for the prevention and control of zoonoses through empowering targeted communities as zoonoses cadre This guide can be used by communities in Indonesian’s districts under animal health services supervision for prevention and control of zoonoses through disease detection, report, and response

23. Control strategies Lessons learned + Annual MDV campaign   + High quality vaccines   + Sweeping vaccination   + Emergency vaccination   + IBCM protocol + DPM + Rabies public awareness Not fast enough or wide enough https://pubmed.ncbi.nlm.nih.gov/31564729/   Lessons for integrated rabies control and elimination FAO’s Support on Integrated Rabies Control in Indonesia

24. Lessons for integrated rabies control and elimination FAO’s Support on Integrated Rabies Control in Indonesia Comprehensive island-wide MDV campaigns should be conducted annually with high quality vaccines in all villages  on as short time as possible and aim to achieve high coverage (minimum 70%) Supplementary vaccinations should target puppies born after campaigns and unvaccinated dogs missed during campaigns-involving all sectors including veterinary surgeons/practitioners Emergency response vaccinations should be  implemented rapidly and cover sufficient radius of risk areas Targeted surveillance through IBCM , coupled with increased public awareness, is a sensitive and efficient way to increase case detection DPM strategy implemented to encourage responsible dog ownership, with a focus on vaccinating dogs, particularly puppies , to maintain high levels of vaccination coverage Creating awareness for children and students is effective to send messages to their parents and their communities.

25. Options to enhance rabies control in future FAO’s Support on Integrated Rabies Control in Indonesia The usage of other funding resources to strengthen rabies control program in Bali: Dana Desa,  Biaya Tak Terduga (BTT), Dana Siap Pakai (DSP) Increased puppy vaccination (involving private practitioners and IVMA) Oral rabies vaccination for roaming dogs/hard to catch and handle dogs Increased community involvement: zoonoses cadre   Expand the DPM and responsible dog ownership to the whole of Indonesia Children Declaration for Indonesia to be Free of Rabies by 2030, at World Rabies Day, 2019

26. Thank you!