Rabies has been declared a notifiable disease in Bhutan and rabies control activities are coordinated at the national level. Livestock Act of Bhutan 2001 and Livestock Rules and Regulation 2017 cover an aspect of zoonotic disease (including rabies) management. However, some form of control has been initiated in early 1990s when dog rabies became endemic even in the capital city, Thimphu. Some form of planned activities were only initiated in the mid-2000s, however they were implemented by sector (Public Health and Veterinary sectors). By the late 2000s joint activities with the Department of Pubic Health were initiated and the national rabies prevention and control plan 2017 specified the roles and responsibilities of various stakeholders for the prevention and control of rabies in Bhutan. The Human Rabies Management Guideline 2014 also covers aspects of dog bite and rabies case management as well as reporting for surveillance and standard recommendations for rabies PEP in human.
The Bhutan One Health Strategic Plan (2017-2021) has been approved by the government and an MoU signed between the two key Ministries and countersigned by other relevant stakeholders. To implement the strategy, a Bhutan One Health Secretariat (BOHS) has been formally agreed to be established at the Royal Centre for Disease Control (RCDC), Department of Public Health, Ministry of Health. Activities under the secretariat are to be coordinated by two secondees from the two sectors whose appointment is to be realised soon.
However, activities on zoonoses including rabies continues to be implemented jointly between the two key sectors since the late 2000s. Ever since the start of the joint activities in 2008-2009 following One Health Approach (multi-sectoral collaboration) Bhutan did not experience any human rabies case from 2011 to date, except one case each in 2013 and 2016 at the southern border districts.
Strategic Plan for Elimination of Dog Mediated Human Rabies by 2023 and Rabies Freedom by 2030
In 2018 a team of experts from the Ministry of Health and Ministry of Agriculture and Livestock jointly developed a truly One Health Approach Plan for Rabies aimed at eliminating dog-mediated human rabies by 2023. The guiding principles for the development of the plan were:
Joint Plan:
The joint plan, which was developed in line with the Bhutan One Health Strategic Plan has been submitted to the two Ministries for official recognition/endorsement. It is expected to be realised soon after the parliamentary election in October 2018.
Goal:
To eliminate dog-mediated human rabies by 2023 and maintain freedom through 2030 in Bhutan
Main Objectives:
The following are the key strategies that will be implemented to achieve rabies elimination plan in Bhutan.
Government agencies:
Local government: Thromdeys (Municipal Corporations), Dzongkhags (Districts) and Geog (Block) administrations;
Others: Bhutan Chamber of Commerce and Industries (BCCI) and private individuals.
Regional and international organizations: SAARC, WHO, OIE, FAO
NGOs: HSI, VBB and relevant local NGO’s and animal welfare organizations