Estimating the economic impact of canine rabies to Viet Nam 2005–2014

The global economic impact of canine rabies has been estimated by several studies. Asia bears a disproportionate burden of this zoonosis due to high levels of human deaths and rates of post-exposure prophylaxis (PEP), but low investment in preventative dog vaccination. The same factors that cause rabies to burden much of Asia are also present in Viet Nam. This study estimated the economic burden of canine rabies in a societal perspective including direct and indirect cost of rabies in dogs, livestock, and humans. Using data collected from personal interviews, published literature, published and supplementary reports, and primary data collection, we estimated the economic impact of canine rabies in Viet Nam over a ten year period (2005–2014). We incorporated the direct and indirect costs for PEP, dog vaccination efforts, livestock losses, and disability adjusted life years (DALYs) into the analysis. General findings from this analysis indicated that over the 10 year study period, the total economic impact of canine rabies was over $719 million USD. The largest portion of impacts (92%) were made up of PEP-related costs. Canine rabies created between 36,560 and 45,700 DALYs, measured in years of life lost (YLL). A total of 914 human deaths were reported over the study period. Deaths/100,000 people were 0.11, which is lower than the reported level for Asian countries. The cost per dog vaccinated was $1.75 USD. Our results indicate that canine rabies impacts in Viet Nam are consistent with the burden elsewhere reported in Asia, with large expenditures on PEP and very small investments in dog vaccination.Author summary: With few exceptions, canine rabies is endemic in developing countries. The mortality rate of rabies approaches 100%. However, disease is preventable via the timely administration of post-exposure prophylaxis (PEP) following a rabid animal bite. Additionally, canine rabies can be controlled in dog populations through mass vaccination. Economics drive the majority of policy and decision making and as such, a robust understanding of the cost of prevention and control methods is useful for the development and implementation of rabies management strategies. The majority of afflicted individuals are poor and reside in rural regions, where knowledge of rabies is minimal and access and affordability of PEP are limited. A greater emphasis on mass dog vaccination is a cost effective method of eliminating canine rabies at the source, which decreases the need for human PEP and reduces the burden of human mortality within vulnerable populations.