Gavi, the Vaccine Alliance, in collaboration with partners, is launching a new initiative to support human rabies vaccines for post-exposure prophylaxis (PEP) as part of routine immunisation. Eligible countries are being guided on how to access these vaccines under Gavi’s cofinancing policy, with the first round of applications open until mid-July 2024.

Rabies, a viral disease causing severe brain inflammation, is nearly 100% fatal once symptoms appear. Ninety-five percent of human rabies deaths occur in Africa and Asia, primarily in marginalized communities without access to care. This initiative is part of the global Zero by 30 campaign, which aims to eliminate dog-mediated human rabies by 2030. The campaign is 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).

“This commitment from Gavi is crucial and will expedite efforts to halt human fatalities caused by dog-mediated rabies,” said Dr. Jérôme Salomon of WHO. WHO will provide technical assistance to help countries apply for Gavi funding and develop comprehensive action plans toward the Zero by 30 goal.

In over 150 countries where dog rabies remains a serious public health issue, public health systems often have limited stocks of human rabies vaccines. The cost of PEP through private facilities can impose a significant financial burden on families and communities.

“Gavi’s aim with this program is to save lives by ensuring that human rabies vaccines are available to anyone who needs them, especially in vulnerable and marginalized communities,” said Aurélia Nguyen, Chief Programme Officer at Gavi.

Rabies is transmitted to humans by rabid dogs in 99% of cases. It is preventable through prompt PEP, which includes thorough wound washing, a course of human rabies vaccine, and immunoglobulins if needed.

Gavi initially planned to include human rabies vaccines for PEP in its 2021-25 Vaccine Investment Strategy, but the COVID-19 pandemic delayed the program until mid-2023.

“Gavi’s investment is crucial to the global strategy to stop rabies deaths,” said Professor Lucille Blumberg, Chair of United Against Rabies. “However, stopping human rabies deaths requires better data and surveillance, dog vaccinations, and public education on avoiding and responding to bites. It will take multiple sectors working together to achieve this goal.”

All Gavi-eligible countries can apply for support to invest in human rabies vaccines for PEP. Funding covers vaccine procurement and associated supplies but not rabies immunoglobulins (RIG) or dog vaccines. While a national rabies control plan is not required for the first round of funding, it will be mandatory for future applications. Gavi will accept funding applications until 15 July 2024 and 23 September 2024, with subsequent funding windows opening three times a year.