RESUMO
Rabies is still one of the deadliest diseases known to exist in the 21st century, and yet it remains irresponsibly neglected and underestimated. In light of this, this paper discusses the principles of governance as they relate to rabies control, using examples of global intersectoral coordination programmes for the control of canine rabies and for the elimination of human rabies transmitted by dogs. The first of these programmes was the Meeting of Rabies Program Directors of the Americas (REDIPRA), which has served as a model of intersectoral success for rabies elimination in other regions. Examples of intersectoral cooperation on several continents, mainly between the health and agriculture sectors, are detailed to discuss various methods of achieving better technical cooperation. These cooperation programmes follow the 'coalition model' set by REDIPRA. They bring together various actors, such as governments, non-governmental organisations, the private sector, the science and research community, international cooperation agencies and donors, under a common umbrella for advocacy and for the implementation of local projects for the elimination of human rabies transmitted by dogs. Networking is the main intersectoral governance mechanism presented in this review.
Bien qu'elle soit connue pour être l'une des maladies faisant le plus de victimes au xxie siècle, la rage demeure fortement négligée et sous-estimée, traduisant un déficit de responsabilité en la matière. À la lumière de cet état de fait, les auteurs examinent les principes de gouvernance applicables à la lutte contre la rage, en prenant pour exemples les programmes mondiaux destinés à assurer la coordination intersectorielle de la lutte contre la rage canine et de l'élimination de la rage humaine transmise par les chiens. Le premier des programmes examinés est celui mis en oeuvre par les Réunions des Directeurs des Programmes nationaux de contrôle de la rage en Amérique latine (REDIPRA), qui a servi de modèle dans d'autres régions du monde en tant qu'exemple de coopération intersectorielle réussie pour l'élimination de la rage. Les auteurs examinent en détail quelques exemples de coopération intersectorielle dans différents continents et portant pour la plupart sur les secteurs de la santé et de l'agriculture, ce qui les conduit à mettre en avant les méthodes permettant d'améliorer la qualité de la coopération technique. Ces programmes de coopération s'inspirent du « modèle de coalition ¼ inauguré par les REDIPRA. Ils réunissent plusieurs acteurs tels que les gouvernements, les organisations non gouvernementales, le secteur privé, la communauté des chercheurs et des scientifiques, les agences de coopération internationale et les donateurs, autour d'un objectif commun axé sur la promotion et la mise en oeuvre des projets locaux d'élimination de la rage humaine transmise par les chiens. Le travail en réseaux est le principal mécanisme de gouvernance intersectorielle présenté dans cette analyse.
La rabia es todavía una de las enfermedades más mortíferas que se conocen y aún subsisten en el siglo XXI, pese a lo cual sigue estando, de forma harto irresponsable, desatendida y subestimada. Ante tal realidad, los autores exponen los principios de la gobernanza en relación con la lucha antirrábica, ofreciendo ejemplos de programas de coordinación intersectorial a escala mundial para combatir la rabia canina y eliminar la rabia humana transmitida por perros. El primero de tales programas fue la «Reunión de directores de programas contra la rabia de las Américas¼ (REDIPRA), que después ha servido de modelo de labor intersectorial eficaz para la eliminación de la rabia en otras regiones. Tras describir en detalle ejemplos de cooperación intersectorial en varios continentes, básicamente entre los sectores de la agricultura y la salud, los autores examinan varios métodos para dotar de más eficacia a la cooperación técnica. Estos programas de cooperación siguen el «modelo de coalición¼ establecido por la REDIPRA: se trata de federar a distintos interlocutores (gobiernos, organizaciones no gubernamentales, entidades del sector privado, círculos científicos y de investigación, organismos de cooperación internacional, donantes, etc.) en torno a un designio común de sensibilización y aplicación de proyectos locales para eliminar la rabia humana transmitida por perros. El trabajo en red es el principal mecanismo de gobernanza intersectorial que presentan los autores en estas líneas.
Assuntos
Erradicação de Doenças , Política de Saúde/legislação & jurisprudência , Cooperação Internacional/legislação & jurisprudência , Raiva/prevenção & controle , Animais , Notificação de Doenças , Cães , Humanos , Vacina Antirrábica/administração & dosagem , Vacina Antirrábica/imunologiaRESUMO
Paraguay has registered no human cases of rabies since 2004, and the last case in dogs, reported in 2009, was due to a variant maintained in the common vampire bat "Desmodus rotundus". In 2014, a dog was diagnosed as positive for rabies with aggression towards a boy and all required measures of control were successfully adopted. Epidemiological investigation revealed that the dog was not vaccinated and had been attacked by a crab-eating fox, "zorro" (Cerdocyon thous). The sample was diagnosed by the Official Veterinary Service of the Country and sent to the Center on Rabies Research from the University of São Paulo, Brazil, for antigenic and genetic characterization. A second sample from a dog positive for rabies in the same region in 2015 and 11 samples from a rabies outbreak from Asuncion in 1996 were also characterized. The antigenic profile of the samples, AgV2, was compatible with one of the variants maintained by dogs in Latin America. In genetic characterization, the samples segregated in the canine (domestic and wild species)-related group in an independent subgroup that also included samples from Argentina. These results and the epidemiology of the case indicate that even with the control of rabies in domestic animals, the virus can still circulate in wildlife and may be transmitted to domestic animals and humans, demonstrating the importance of continuous and improved surveillance and control of rabies, including in wild species, to prevent outbreaks in controlled areas.
Assuntos
Doenças Transmissíveis Emergentes/veterinária , Reservatórios de Doenças/veterinária , Doenças do Cão/virologia , Vírus da Raiva/genética , Raiva/veterinária , Animais , Antígenos Virais/genética , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/virologia , Surtos de Doenças/veterinária , Doenças do Cão/epidemiologia , Cães , Humanos , Paraguai/epidemiologia , Filogenia , Raiva/epidemiologia , Raiva/virologia , ZoonosesRESUMO
South America has a favourable position with respect to foot-and-mouth disease (FMD) compared with other FMD-affected regions due to the elimination of endemic clinical presentation of the disease. South America has reached the final stage of control and aims to eradicate the disease in the region under the provisions of the Hemispheric Program for the Eradication of FMD 2011-2020 (PHEFA). This programme aims at bringing eradication to completion, thereby eliminating the pool of foot-and-mouth disease genotypes active in South America. This plan includes a regional political agreement that provides strategies and technical guidelines for the eradication of foot-and-mouth disease from South America. It incorporates knowledge and experience regarding the disease's history and its connection with the different production systems, animal movement and trade. The Pan American Foot and Mouth Disease Center has led the control and eradication programmes, providing the framework for designing national and subregional programmes that have led to significant progress in controlling the disease in South America. The current situation is the result of several factors, including the proper implementation of a national control programmes, good veterinary infrastructure in most countries and public-private participation in the process of eradicating the disease. Notwithstanding the favourable health status, there are significant challenges for the goal of eradication. At this stage, South American countries should enhance their surveillance strategies particularly through the use of target or risk-based surveys that contribute to increase the degree of sensitivity in the search for viral circulation in the context of absence of clinical occurrence of FMD.