Rabies control programmes are being implemented across the Philippines, with a number of islands and provinces on track for the elimination of both human and dog rabies [1,2]. In spite of considerable progress in control programmes, costs of post exposure prophylaxis (PEP) remain high with bite incidence rapidly increasing every year. Indiscriminate PEP administration can strain healthcare budgets, and eventually redirect focus from essential mass dog vaccination campaigns. It is an ethical imperative to improve access to PEP for those at risk; however, under the current framework operating in the Philippines, indiscriminate PEP administration results in excessive expenditure on non-case patients and subsequent financial strains and vaccine shortages, whilst vulnerable communities remain undetected. At the same time, incursions represent an obstacle to achieving and maintaining rabies freedom [3,4]and have been shown to pose a threat to elimination goals [5]. The lack of formal surveillance is the primary cause, leading to late detection of disease at which point substantial secondary transmission within the dog population already occurs. There is, therefore, an urgent need to enhance and streamline surveillance to maximize detection potential for rapid outbreak response and to guide policy decisions regarding public health practice. Workable surveillance criteria are needed for more judicious and effectiveuse of PEP to identify high risk exposures and thus prevent unnecessary risk and further transmission when vaccine stocks are limited.
Objective: To evaluate public health and economic impact of intersectoral One Health enhanced surveillance strategies of canine rabies in the Philippines to inform vaccine procurement and provision plans.