RFA-CK-22-002, Adaptation and assessment of smartphone technology to improve the implementation and evaluation of One Health systems for rabies control and surveillance globally

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1 Project summary 2 Rabies is one of the most devastating diseases, with near 100% case fatality once clinical signs occur. 3 The vast majority of the tens of thousands of human deaths from rabies every year occur in low- to 4 middle-income countries (LMICs) of Africa and Asia, transmitted through a bite from a rabid dog. 5 Unlike many neglected tropical diseases, rabies is entirely preventable through timely provision of 6 post-exposure prophylaxis (PEP) and elimination through mass vaccination of the dog population has 7 been demonstrated to be both achievable and cost-effective. Nevertheless, children and those at 8 the socioeconomic and geographic margins of society are more likely to die of rabies due to 9 inequities in access to public health services and education, often dying in horrific circumstances 10 without any palliative care. Poor data quality, stemming from limited field-level collection, has been 11 implicated as the singularly most important barrier to rabies control, clouding evidence-based 12 policies and hampering successful control measures. Smartphone and online technologies have 13 revolutionized connectivity between program managers and their remote workforce, enabling field- 14 side digital capture and transmission of programmatic data and spatial communication through 15 interactive maps. The resulting high-resolution data on host population distribution and spatio- 16 temporal rabies case incidence provides new opportunities to optimize control strategies for efficacy 17 and cost-efficiency. This project builds on a long-established program of rabies control interventions 18 across Latin America, Asia and Africa and a versatile platform of technologies developed to support 19 mass dog vaccination and surveillance activities. Further technology development will focus on 20 facilitating widespread democratization of systems, integration with national and international 21 platforms and approaches to support data-driven planning and refinement of rabies control 22 campaigns. Automation of processes for mapping, post-vaccination evaluation and reporting will 23 serve to align strategies and protocols with evidence-based international best-practices for 24 campaign implementation and stimulate engagement with stakeholders at all levels. The impact of 25 novel approaches to the geographic prioritization of vaccination resource on campaign efficiency 26 and rabies transmission will be evaluated. Automated in-app guidance for vaccination team 27 direction, PEP regimen scheduling and the investigation of suspect rabid dogs will be evaluated as 28 compared to non-technology aided approaches. Outcomes of the project will unlock in-country 29 capacity for the implementation of effective One Health rabies control interventions and accelerate 30 progress towards the 2030 global goal for dog-transmitted human rabies elimination.