All hands-on deck to fight the ‘zombie’ rabies virus

Under the scorching Balinese heat in July, the village leader of Desa Singapadu Tengah in Gianyar Regency led a team of local vets and volunteers house-to-house to vaccinate pets and stray dogs against rabies.

Pak I Made Sudarta was one of the Gianyar community representatives in a team of 90 people who had mobilized for a two-day rabies vaccination campaign organized by Boehringer Ingelheim in collaboration with local government authorities. The joint goal was to address the escalating concerns about rabies in his village, which had reported 23 confirmed cases from January to July 2024.

He recently experienced first-hand how life-changing exposure to the deadly virus can be. His daughter was bitten by a community dog during a casual interaction and is currently being monitored for rabies symptoms – over the next three months.

Pak Made holding two dogs — **Pak Made** **wants to protect his family and ensure his community is safe from rabies.**

Dogs stray, making rabies difficult to control

The free-roaming, unvaccinated dog population has been identified as a cause for the rise in rabies cases in Gianyar. However, this issue is common to the province and also poses a major challenge across Southeast Asia.

The large population of free-roaming dogs, low vaccination coverage, and cross-border transmission in the region are putting millions of people at risk of rabies exposure, especially in underserved communities. In line with our sustainability goals , we aim to expand access to healthcare for 50 million people living in underserved communities. This includes working together with partners towards eliminating rabies.

The extent of the continuous effort can also be seen in Marinduque, Philippines: Once a rabies-free province, it declared a ‘state of calamity’ after becoming infected again in 2023. Due to dogs roaming the streets in search of food and a lack of monitoring of dog movements, the resurgence had reportedly infected nearby animals and resulted in two human fatalities.

Field Epidemiology Training Program Alumni Foundation, Inc. (FETPAFI), in collaboration with the MIMAROPA Department of Health and Department of Agriculture, is leading a list of recommendations to control the rabies outbreak in the province. These recommendations include a provincial integrated human and animal health mandate to address future zoonotic disease outbreaks.

FETPAFI team — **FETPAFI aims to strengthen epidemiology, disease prevention, and control capabilities to improve the country’s public health.**

Buddy up, expanding beyond the healthcare network

Through our ‘Stop Rabies’ initiative, we’re working to deliver on-the-ground solutions to prevent the disease. Successful rabies prevention management strategies implement an interconnected health approach extending beyond animal and human healthcare ecosystems.

Encouraging dog owners to be responsible and supervise their dogs’ movements, so they do not roam freely in public places, is crucial to preventing and controlling rabies. Communities, especially the children, need to be better aware of how to safely interact with dogs and the need to seek immediate medical consultation when bitten by an animal.

To protect these communities, better education on rabies prevention in school curricula will be crucial, since children under the age of 15 account for 40% of rabies deaths globally. In collaboration with the Malaysia One Health University Network (MyOHUN), Boehringer Ingelheim co-developed a rabies education, “train-the-trainer" program for primary and secondary school teachers in high-risk zones of Sarawak, Malaysia.

Dr Rosalia aims to transfer her knowledge and foster healthier generations ahead.

Antidote for a new reality

Fighting a ‘zombie’ virus is hard work and requires courage. The rise in rabies cases across Southeast Asia calls for multi-level, cross-sectoral attention and action to manage this preventable disease through dog vaccination, education, and surveillance solutions. Engaging affected communities is crucial. By uniting to improve health for humans and animals, we can create a better future, where a rabies-free Southeast Asia becomes the new reality and ‘zombie’ viruses only appear in fiction.