Rabies in Myanmar: Prevalent, Preventable but not Prioritized

Abstract

Despite the availability of proven measures to prevent the disease, rabies now kills more people in Myanmar than malaria. Although there are challenges in controlling rabies in such a large and culturally diverse country, Myanmar's successful National Malaria Control Program demonstrates what can be achieved with sufficient political, financial, and scientific commitment. Presently, however, Myanmar lacks a comparable program to coordinate the multifaceted approach that is necessary to control rabies. The national government has invested heavily in improving access to postexposure prophylaxis, but there should also be an emphasis on other, more cost-effective strategies, particularly mass canine vaccination, which has been an essential component of successful rabies elimination programs in other countries. Continued health system strengthening is also required to improve primary health care, while decentralization of laboratory diagnostic services is needed to facilitate more timely, rational, and cost-effective use of postexposure prophylaxis.

Figure 1.

Deaths from malaria (panel A) compared with deaths from rabies (panel B) in Myanmar 2006–2015 (Data from the Health Management Information System, Department of Public Health, Union of the Republic of Myanmar). This figure appears in color at www.ajtmh.org.

Figure 2.

Deaths from rabies and malaria (per 100,000 population) in Myanmar 2006–2015 (Data from the Health Management Information System, Department of Public Health, Union of the Republic of Myanmar). This figure appears in color at www.ajtmh.org.