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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 50

current and future health challenges at the human-animal-environment interface. In response to this
challenge, they drafted the One Health Joint Plan of Action (OH JPA), 2022-2026, which describes their
collective commitment to advocate for and support One Health initiatives in accordance with six action
tracks. The prevention and control of rabies is categorized under action track 3 which aims to “control and
eliminate endemic zoonotic, neglected tropical and vector-borne diseases”. The necessary interventions to
achieve this objective, as outlined in the OH JPA, are as follows: implementation of community-centric,
risk-based solutions; strengthening of policy and legal frameworks across different levels and sectors; and
increase political commitment and economic investment in rabies prevention and control programmes [37,38] .
Such activities are in-line with the Rabies Blueprint and the Rabies Roadmap; developed by experts in the
field, these documents provide nations with actionable, step-wise guidance and measurable objectives in the
quest to eliminate dog and fox-mediated rabies under a One Health approach [39,40] .

The Colombian political commitment towards the rabies surveillance, prevention and control program has
been crucial for its success. The last rabies integrated surveillance protocol launched in 2022 is a proven
testimony that official entities are willing to support the integrated activities among sectors . In the
[41]
author’s opinion, mainstreaming One Health principles, especially those associated with equity, inclusion
and access, should be taken as priority to evaluate Colombia’s historical vaccination actions in tackling
rabies and to plan the future for the national zoonoses control program. Our findings indicate that the
greatest success has been demonstrated when Ministries have promoted cross-disciplinary cooperation,
bringing together a range of relevant stakeholders to implement system-wide activities. Consequently, we
encourage and urge the immediate adoption of a One Health approach within already existing intersectoral
mechanisms, such as the National Zoonoses Council, and already existing health policies. Having identified
heterogeneity of vaccination coverage among domestic felines and canines, a primary focus of the National
Rabies Colombian Program (NRCP) should be to promote the expansion and intensification of vaccination
campaigns, particularly among rural populations of these animals, combined with targeted health
promotion campaigns directed at rural populations. Importantly, interventions should also be designed to
address the economic, social and cultural disparities between rural and urban populations to reduce the
neglect of remote communities, particularly indigenous populations, that threatens the success of universal
rabies control in Colombia. Additionally, surveillance among domestic animal populations (including
cattle) should be integrated with that of wildlife populations, particularly bats and foxes. In addition to
being more cost-effective, such an approach will address the primary vectors of human rabies infection,
evidenced by the fact that all human rabies cases have occurred by either unvaccinated cats infected with bat
rabies or direct contact with vampire bats since 2008. With respect to the human element of the One Health
triad, the fragmentation of prevention programmes resulting from changes in national health law was
identified as a major factor in their declining success in recent decades. To overcome this, transdisciplinary
methods of working must be introduced to promote integrated actions and monitoring between
stakeholders, with a particular emphasis on the inclusion of indigenous and other marginalized voices. This
requires strong political willpower to ensure funding, good governance, coordination, and leadership.
However, bureaucracy, administrative challenges and regular changes in government leadership present
major obstacles to this. Moreover, the decline in funding for healthcare, including infectious disease
interventions, and fragmentation of the health sector in recent decades demonstrates declining political
commitment which, as evidenced, has had detrimental implications on rabies control activities in Colombia.
Consequently, strong community engagement with the general public, combined with collaboration from
international agencies and non-government organizations (such as the Red Cross, UNICEF, doctors
without borders, etc.), must be promoted to lobby political commitment. This will, in turn, enable
formalization of agreements irrespective of governance changes and ensure sustainable, impactful
engagement from the public political sector which puts One Health at the centre of its principles. Rabies,
like all infectious diseases, does not respect borders. As such, concerted efforts must be made for