Rabies elimination is the ultimate equity intervention in settings where there is differential access to post-exposure prophylaxis, which is a striking feature of all countries where canine rabies remains endemic.1 Progress towards the 2030 goal of eliminating dog-mediated rabies has stagnated with nearly 60,000 children continuing to lose their lives annually due to this vaccine-preventable disease.
There is a need to bolster and update the rabies elimination toolkit. Thus, Lodha et al’s plea to employ the opportunity provided by pre-exposure childhood immunisation in rabies-endemic settings should be heeded, in addition to optimising mass dog vaccination, post-exposure prophylaxis and public awareness.2
A potential game-changer for ensuring effective rabies immunisation, whether pre-or post-exposure, particularly in hard-to-reach communities was unfortunately not mentioned. Microarray patches (MAPs) present a tantalising opportunity to: increase ease of administration, transport, storage and safe disposal after administration; provide thermostable potent vaccine in remote areas plagued by power outages; be dose-sparing; promote adherence through decreased discomfort; and, with the reduced skill-level required for administration, possibly permit self-administration of rabies immunisation doses.3
MAPs were prioritised in the top three innovations needed to expand immunisation protection in low and middle-income countries in May 2020, and PATH has provided a target product profile.4,5 It is now crucial to accelerate rabies-vaccine MAP development—many young lives are at stake!
Contributors
DND conceptualised, prepared and reviewed this contribution.
Declaration of interests
I declare no competing interests.
Acknowledgements
None.
References
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