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Cediel-Becerra et al. One Health Implement Res 2023;3:42-54 https://dx.doi.org/10.20517/ohir.2023.01 Page 46

Figure 1. Key One Health components of the “Cali Free of Canine Rabies” campaign in Colombia, 1969.

control programs for the urban cycle of disease, being unequally performed around the country, particularly
neglecting remote, rural locations. This fragmentation also affected the National Institute of Health (INS).
Between 1994 and 2000, the laboratories for the production of vaccines and serums were closed, including
those for human and canine rabies which had produced batches of 80 thousand doses per month. This was
due to the limited budget to sustain their operation. The facilities required a multi-million dollar investment
to adapt them to the international standards of PAHO, and it was cheaper to import vaccines or to purchase
the products from private laboratories. The Vecol laboratory also ceased production of human vaccines as
of 2003, subsequently only providing vaccines for veterinary use . Consequently, Colombia went from
[1]
exporting biologics to different countries around the world to importing vaccines and suffering shortages,
particularly in outbreak situations. Despite this, throughout 1997, various outbreaks were controlled across
Latin America through the establishment of mass canine prophylaxis campaigns. As a result, genetic variant
1 is now extremely rare; genetic variant 2, however, continues to circulate in Magdalena, the Caribbean, and
accounts for the majority of cases in Colombia to this day. This presents a significant ecosystem health
threat, as explored within the subsequent section, this region in Colombia continues to present a foci
location for the transmission of rabies variant 2 in foxes .
[14]

2000 until present day
The rabies activities over the recent two decades paint a complex picture.

Domestic animals and livestock
With respect to domestic animals, the Colombian government prioritized dog rabies vaccination in
[15]
hotspots, thus creating a heterogeneous profile of vaccine coverage across the country . As such, despite
average immunization coverage increasing from 45% in 1994 to 63% in 2005 and no canine-associated
rabies fatalities in humans since 2007, only a quarter of all Colombian departments have a coverage greater
[15]
than 60% - and these are likely overestimates . Rabies vaccination coverage in Bogota was found to be just
43% in 2011, one of the lowest in the last twenty years and vastly under the WHO-recommended coverage
of 70% for outbreak prevention [16,17] . The same study demonstrated that some areas of the city had low