Mission accomplished!
Dr Tep Bengthay, the Deputy Director of the Department of Animal Health and Veterinary Public Health and General Directorate of Animal Health and Production, is smiling proudly about this achievement: “It is an important element in contributing to the elimination of human deaths from dog-mediated rabies by 2030 in Cambodia and key to being replicated in all other provinces.”
Cambodia achieved a great feat by successfully completing the largest government-led mass dog vaccination campaign to date. A prerequisite of the German Development Cooperation (GIZ) was that the Global Programme for Pandemic Prevention and Response, One Health should be implemented using existing government structures. All activities included the animal and human health sectors. Furthermore, close collaboration was maintained with the World Organisation for Animal Health (WOAH), the World Health Organization (WHO), the Pasteur Institute of Cambodia and Mission Rabies as relevant actors in fighting rabies.
Another key element to mass dog vaccination was the implementation of integrated bite case management (IBCM) in Battambang province. A formal agreement among the different sectors as well as several awareness-raising and training activities with local human and animal health care staff now ensure that a dog bite incident triggers investigations by both sectors. The Deputy Director of the Department for Communicable Disease Control at the Ministry of Health, Dr Yi Sengdouern, appreciates the progress of joint activities based on existing systems between the animal and human health sectors. Over a period of 10 months, investigators examined almost 1000 suspected rabies cases, with laboratory testing carried out on 25 dog samples. “The strengthened cross-sectoral collaboration including the workstream of IBCM is very important for Cambodia and has high potential to be scaled up – towards reaching Zero by 2030 for rabies in our country”, he said.
A third essential pillar of the approach is increased access to rabies post-exposure prophylaxis (PEP) services, as currently only one third of Cambodia’s population lives within reasonable reach of a PEP centre. For the first time, PEP services have been made available at Kampot Provincial Referral Hospital and announced to the public. The Deputy Director of the Kampot Provincial Health Department, Dr Tann Chheng, highlighted the current successes of the improved PEP service in reducing the burden of expenditure due to direct and indirect costs: “This clearly contributes to reducing morbidity and mortality of bite victims!” Within the first 6 months of introduction, about 700 people who had suffered bites received PEP services.
To underpin the pilot activities, support was provided at the policy level to develop national guidelines for rabies surveillance, prevention and control. Further, a joint study visit was made to Viet Nam by both sectors. “I am glad to join the study visit to Viet Nam together with my colleagues from the animal sector. I am particularly interested in learning from Viet Nam’s approach to how the sectors and the local authorities developed such great collaboration, coordination and communication at the community level,” said one of the participants, Dr Ouk Vithiea, Deputy Director of the Provincial Health Department in Battambang. Insights from Viet Nam’s national rabies control programme have strengthened networking between Cambodia and Viet Nam, particularly in anticipation of the upcoming regional ASEAN Rabies Elimination Strategy. 
Support for rabies diagnostics includes joint activities with the various laboratory trainings of the Pasteur Institute of Cambodia, and the development of the National Strategic Plan of the National Animal Health and Production Research Institute. According to the Director of the National Animal Health and Production Research Institute (NAHPRI), Dr Tum Sothyra: “The support from GIZ is in line with the overall goals of NAHPRI in strengthening and improving the diagnostic capability of NAHPRI to cover rabies and other zoonotic diseases including neglected tropical diseases. This capacity allows us to detect and respond to disease outbreaks in a timely manner.”
All activities are accompanied by tailored awareness-raising efforts, including the development of a massive open online course on rabies for schoolteachers with the goal of enhancing their understanding of teaching rabies prevention to children.
“The One Health approach strengthens cross-sectoral collaboration among sectors at national and subnational levels, which is required in order to be effective in fighting neglected tropical diseases including rabies”, added Dr Yi Sengdouern. 
Photos credits: WHO/Cambodia
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