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Page 43 Cediel-Becerra et al. One Health Implement Res 2023;3:42-54 https://dx.doi.org/10.20517/ohir.2023.01

history of rabies control in Colombia through a One Health approach, we present some lessons learned and
propose improvements for the country’s long-term rabies vaccination programmes through the integration of
human and animal (both domestic and wild) activities in vaccine production and roll-out. Furthermore, we highlight
the importance of engaging various government, academic, private, non-government agencies and general public
stakeholders in rabies control and prevention programs, especially those in remote rural settings. Finally, we
present a proposal to create the national One Health Strategic Action Plan to support the operationalization of a
cross-sectoral integrated zoonoses control programme in Colombia.

Keywords: Rabies, one health, vaccination, cats, rural, Colombia

INTRODUCTION
Historically, Colombia has been recognized for its leadership in the control of canine rabies in the Americas
[1]
region due to its extensive and inclusive vaccination campaigns . However, the decentralization of public
health services in the 90’s generated key challenges, including access barriers, weak governance, and the
[2]
involvement of multiple actors with scarce coordination and lack of an integrated information system . The
rabies national control program in Colombia was also hindered by the fragmentation and specialization
across sectors, resulting in two separate national programmes: one focused on animal health in the
countryside, the other orientated around human health in large, populated areas. However, since 2008,
increasing evidence demonstrates cats, not dogs as is usual, are primarily responsible for human infection
[3]
with rabies in Colombia and, crucially, transmit wildlife variants of the virus . The role of cats as focal,
non-reservoir vectors of wild rabies variants in the nation demonstrates the need for a combined approach
for long-term prevention planning under a One Health approach. Published by the One Health High-Level
Expert Panel (OHHLEP) in 2022, the new definition of One Health aims to sustainably balance and
optimize the health of people, animals, and ecosystems. It recognizes that the health of humans, domestic
and wild animals, plants, and the wider environment (including ecosystems) are closely linked and
interdependent. It promotes cross-disciplinary, multisectoral collaboration at varying levels of society,
including communities, to work together to foster well-being and tackle threats to health and ecosystems,
while addressing the collective need for healthy food, water, energy, and air, taking action on climate change
and contributing to sustainable development. The framework proposes basic principles to guide action:
equity, inclusivity, equal access, parity, socio-ecological equilibrium, stewardship and transdisciplinarity .
[4]

With human cases resulting from animal (both wild and domesticated) interactions, which are in turn
underpinned by sociopolitical and environmental dynamics, rabies is, at its core, a One Health issue.
Employing this approach, we evaluated the history of rabies vaccination in Colombia to understand the
strengths and weaknesses of the National Program to guide future interventions. The success of the canine
vaccination campaigns conducted throughout the nation in the 1960s can be used as a model for future
efforts, orientated around stakeholder cooperation at the human-animal-environment interface and
employing vaccination programmes focused on the four C’s (4Cs): communication, coordination,
collaboration, and capacity building. Such principles are critical to expand the national rabies control
programme to enable the integration of domestic feline and wildlife vaccination and surveillance.

THE CHRONICLES OF VACCINATION FOR RABIES CONTROL IN COLOMBIA
Pre- and post-Spanish Colonisation (second half of the 18th century)
Rabies virus transmitted by vampire bats was likely already present in the New World, well before the
Spanish arrival during 1492. However, the intensification of cattle farming by the Spaniards opened an
ecological niche. In providing a constant food supply, bat populations boomed which promoted the onward
transmission of the virus into domestic populations, particularly cattle. Similarly, having been absent among