Culling stray dogs should be last resort: SAPM

KARACHI: Terming the culling to be the ‘last resort’ to deal with the problem of stray dogs, Special Assistant to the Prime Minister (SAPM) on Health Dr Faisal Sultan has called for adopting a ‘mix of strategies’ to control and eradicate Rabies encephalitis from Pakistan.

“Taking the life of a living being goes against ethical and religious principles and, therefore, culling should be the last resort. Vaccinating and sterilising is the humane and, therefore, the preferred approach but given the scale of the challenge, at times a mix of strategies may have to be employed in tackling very compelling public health threats,” Dr Faisal Sultan said while speaking at a webinar in connection with the World Rabies Day 2021.

Organised by the Indus Hospital and Health Network (IHHN) in collaboration with Getz Pharma under Rabies Free Pakistan project, the webinar titled “Let’s eliminate rabies together” was addressed by Director General (DG) Health, Pakistan Dr Rana Muhammad Safdar, Executive Director National Institute of Health (NIH), Islamabad Major General Aamir Ikram, head of Infectious Diseases at IHHN Dr Naseem Salahuddin, Managing Director Getz Pharma Khalid Mahmood, public health expert Dr Wajiha Javed as well as the representatives from all four provinces, infectious diseases experts and the veterinaries.

Nodding to suggestion regarding enhancement of the list of notifiable diseases in consultation with the provinces, the SAPM assured that the Ministry of National Health Services would work for the inclusion of Rabies in the list of notifiable diseases to collect the accurate number of Rabies cases in the country and added that the National Health Data Center at the NIH would also start the disease’s surveillance in this regard.

He maintained that despite devolution of health section to the provinces, the Covid-19 has provided an excellent opportunity to work together with the provinces and added that he has an excellent working relationship with all the provincial health ministers Dr Azra Pechuho from Sindh, Dr Yasmin Rashid from Punjab, KP health minister Taimur Jhagra, Balochistan health minister as well as the health authorities in Gilgit-Baltistan and Azad Kashmir.

The Managing Director Getz Pharma Khalid Mahmood said hundreds of kids were annually dying due to Rabies in Pakistan where stray dog’s population is estimated at 15 million with 2.5 million in Sindh alone and vowed to eradicate the dreaded disease through the humane methods like vaccination and sterilising the dogs in the coming years.

Presenting the burden of Rabies encephalitis in Pakistan, DG Health Pakistan Dr Rana Muhammad Safdar claimed that dog bite cases are grossly under-reported in Pakistan where on average half a million people are bitten by the stray dogs and added that upto 5000 people die every year due to Rabies encephalitis in Pakistan, which is also under-reported.

“Pakistan is currently at stage 1.5 out of 5 according to the Stepwise Approach towards Rabies Elimination (SARE). Punjab and Sindh are the most affected provinces with respect to dog bite incidents and Rabies encephalitis cases,” he said, adding that the situation in Sindh is worst and needs strong interventions and steps to prevent the deaths from the infectious disease.

Pointing out the huge gap in demand and supply of Anti-Rabies Vaccine (ARV), Dr Safdar maintained that according to a study carried out in 2018-19 only 55 percent of the dog bite victims completed vaccination and called for creating awareness among the people and the healthcare workers regarding the Anti-Rabies Vaccination to ensure prevention from Rabies encephalitis, which is 100 percent fatal disease.

Executive Director NIH Major General Aamir Ikram said as per estimates around one million doses of Anti-Rabies Vaccine (ARV) are required as 3000 to 5000 people die every year due to Rabies encephalitis and vowed to meet the growing national vaccine needs by ramping up the production at the National Institute of Health (NIH), Islamabad.

“Large population of stray dogs and unfortunate deaths due to Rabies encephalitis is the real public health issue in Pakistan and there is a need to join hands together by all the stakeholders to deal with this issue”, he added.

Eminent infectious diseases expert Dr Naseem Salahuddin called for using the three doses of ARV intradermally within a week and ensuring availability of immunoglobulin that should be injected immediately around the dog bite wound and said washing the wound thoroughly with water and soap reduces the chances of Rabies by 30 percent.

She urged the authorities of ARV centres at all the district hospitals to train doctors and nurses for the vaccination, create awareness about the disease among the people and called upon the healthcare authorities to make Rabies a notifiable disease and launch a strong surveillance system in this regard.