Gavi Announces Support for Human Rabies Vaccines in Routine Immunization Efforts

In over 150 countries where dog rabies remains a serious public health issue, public health systems often have extremely limited stocks of human rabies vaccines, especially in marginalized communities.

Gavi, the Vaccine Alliance, in collaboration with its partners, has announced support for human rabies vaccines for post-exposure prophylaxis (PEP) as part of routine immunization. Eligible countries are receiving guidance on how to access these vaccines under Gavi’s cofinancing policy, with the first round of applications due by mid-July 2024. This initiative aims to address the 95% of human rabies deaths that occur in Africa and Asia, particularly in marginalized communities lacking access to care.

This development aligns with the ongoing global efforts of the Zero by 30 campaign, led by United Against Rabies partners, including the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH), with the goal of eliminating dog-mediated human rabies by 2030.

“This commitment from Gavi is crucial and will expedite efforts to halt human fatalities caused by dog-mediated rabies,” said Dr. Jérôme Salomon, Assistant Director-General for Universal Health Coverage, Communicable and Noncommunicable Diseases at WHO. “WHO will provide technical assistance to countries, not only to support their funding applications to Gavi but to draw up comprehensive plans of action that can deliver real progress towards the Zero by 30 goal.”

In over 150 countries where dog rabies remains a serious public health issue, public health systems often have extremely limited stocks of human rabies vaccines, especially in marginalized communities. Where available through private facilities, the cost of PEP can impose a catastrophic financial burden on families and communities.

“Gavi’s aim with this program is to contribute to global rabies efforts and save lives by helping countries ensure that human rabies vaccines are available to anyone who needs them and that vulnerable and marginalized communities have equal access to these essential medicines,” said Aurélia Nguyen, Chief Programme Officer at Gavi, the Vaccine Alliance.

Rabies is a viral disease that causes severe inflammation of the brain and is almost always transmitted to humans by a rabid dog. Once clinical symptoms appear, rabies infection is nearly 100% fatal. However, rabies infection is preventable by prompt PEP, which includes thorough wound washing, a course of quality human rabies vaccine, and immunoglobulins if needed.

Initially included in Gavi’s 2021-25 Vaccine Investment Strategy, the human rabies vaccines for PEP program was postponed due to the COVID-19 pandemic. Gavi’s Board decided to restart the program in mid-2023.

“Gavi’s investment is hugely important and underpins a key pillar of the global strategy to stop people dying from this terrible disease,” said Professor Lucille Blumberg, Chair of United Against Rabies. “But to stop human rabies deaths completely, we urgently need better data and surveillance, dog populations must be vaccinated, and people must be educated about what to do if bitten, and how to avoid being bitten in the first place. Stopping human deaths from rabies is within our reach, but it will take multiple sectors working together to achieve it.”

All Gavi-eligible countries can apply for support to invest in human rabies vaccines for PEP. Funding will be available for vaccine procurement and associated supplies, although rabies immunoglobulins (RIG) and dog vaccines are not covered by this program. Countries are not required to have a national rabies control plan in place to apply for the first round of multiyear funding, but a national plan will be mandatory for all subsequent applications.

Funding applications will be accepted by Gavi in 2024 by 15 July and by 23 September 2024, with subsequent funding windows open three times annually.