rabies research & impact - university of glasgow · •the burden of rabies is substantial...
TRANSCRIPT
Field epidemiology
Rabies Research & Impact
Large-scale Interventions
Molecular epidemiology
Surveillance Dog vaccination
Transmission
Socioeconomic Impacts
Community engagement
Disease Burden
Health inequalities & access
Health systems
Disease ecology
Evaluating Impacts
Modelling control & elimination
Strategy & Policy design
Cost-effectiveness
Context
AFRICA >30,000 deaths
$0.75 billion losses $0.01pc on dog vaccination
ASIA ~30,000 deaths $4 billion losses
$0.03pc on dog vaccination
AMERICAS <200 deaths
$0.3 billion losses $0.13pc on dog vaccination
Pre−control Control stage Elimination stage Maintenance stage Rabies free dog population
Epidemic in
rabies−free area
Endemic
Time
Persistent foci.
Risk of re−emergence if
control measures lapse
Rabies no longer detected
Rabies may still be
circulating undetected.
Risk of re−emergence if
control measures lapse
Incursion
may cause outbreak.
Risk of re−emergence if
control measures lapse
Certified free
Case 1: Endemic rabies in sub-Saharan Africa, focus in Tanzania
Case 2: Epidemic in Bali, Indonesia
• The burden of rabies is substantial
• Elimination of rabies through dog vaccination is epidemiologically & operationally feasible & affordable
Case study 1. Building the evidence:
Case study 1. Knowledge transfer
• Knowledge exchange was (mostly) our ‘pathway to impact’
• A range of stakeholders:
– High-level policy making bodies (international organisations, global NGOs)
– Regional networks – Governmental bodies – Professional associations (central / local level) – Communities
• Activities: meetings / workshops, professional training, development & delivery of materials, infrastructure
Meetings / workshops
Training of field personnel
Training of laboratory personnel
Reports, briefings & tools for national governments & international organisations
Evidence collection (testimonials, use of findings by others)
“were instrumental in the development and design of the project for human and dog rabies elimination in developing countries successfully submitted by the WHO….. to the Gates Foundation” Director of NTDs, WHO “Our teams have benefited greatly from the information and guidance in the Canine Rabies Blueprint” GARC Asia Coordinator
“This initiative (National Strategy for Rabies Elimination & Control in Kenya) was stimulated ….by the University of Glasgow” MoH & MoALDF, Kenya
Case study 2 – Research on request
Consultation led to collaboration
Stakeholder identification & Engagement
• Partners mediated: • Consultations that influenced research e.g. exploring culling, modeling strategies
• The influence of research on practice
2013
Case study 2 – Research on request
2013
Case study 2 – Research on request
Island-wide campaigns essential for elimination: saving 500+ lives & $15m over 10 yrs
Empowering stakeholders to turn knowledge into long-term action
• Starting from the perspective of the people we are trying to reach and involving them in the solution: – WHO needs to know / be involved? – What is their EXISTING KNOWLEDGE – HOW CAN THEY CHANGE: What do they need to know? – MESSAGES / MATERIALS tailored to end-users – Understanding their MOTIVATION: Personal, economic,
social, political… – BARRIERS – INVOLVEMENT: How can they become involved in the
solution? – COLLABORATION: Who can help reach them? – ACTION AND SUSTAINABILITY: How do we know it will be
put into action and sustained?
Reports & briefings for NGOs, local & national governments & international organisations
Evidence collection (testimonials, use of findings by others)
“I believe we succeeded to run our program on budget and on time because we had Glasgow’s experts to back us up. It gave us the courage to continue with out plan even under extreme stress” Director BAWA
How to do this better - next steps
• We had no strategy for achieving impact (no guidelines)
• Our science focus on controlling rabies is impactful (Conscious Competence)
• Evaluation critical to demonstrating impact: – Bank information / repositories of evidence
corroborate impact
– Ways of better assessing impacts on health / quality of life / understanding / behaviour?
How to do this better – community engagement
Take-home
• Key research outputs were only a small component
• Collect REF-centric evidence to corroborate impact
• Research that is stakeholder-led/ influenced is easier to make ‘impactful’ (at least in short-term for REF)