Programs of canine rabies control often devote more energy to mass vaccination than to population management. However, some regions of India and Latin America have successfully used programs of spaying and neutering or animal birth control (ABC), combining surgical sterilization

with rabies vaccination, to manage their dog populations (Totton et al., 2010). The ABC approach may be quite challenging and costly. According to some field studies and population demographic models, almost 90% of free-roaming dogs must be sterilized and vaccinated for vaccine coverage to remain above 70%, and to IDH inhibition achieve BMS-387032 in vitro a stable 70% reduction in the dog population within 13–18 years (Totton et al., 2010). Less than 40% surgical sterilization coverage would only maintain the dog population at its original level (Totton et al., 2010). Another option for canine population management is chemical sterilization of male dogs, which has been used in Mexico, Brazil and other countries (Jana and Samanta, 2007, Oliveira et al., 2012 and Soto et al., 2009). However, sterilization efforts should not focus only on males, as females are

also critical target for effective population management (Fielding and Plumridge, 2005 and Jackman and Rowan, 2010). More often, however, rabies control programs have attempted to cull dog populations, even though this approach has been shown to be ineffective (Dalla

Villa et al., 2010, Johansen and Penrith, 2009, Morters et al., 2013 and Rupprecht L-gulonolactone oxidase et al., 2006). Such lethal management strategies require the elimination of 50–80% of dogs a year, which is neither financially possible nor ethically acceptable (Rupprecht et al., 2002). As shown in Fig. 1, most cases of human rabies can be prevented by eliminating the disease in dogs, through a combination of Rupprecht et al., 2008 and Wunner and Briggs, 2010: • appropriate risk-assessment programs, including laboratory confirmation or 10–14 day observation of animals causing a bite injuries or other potential exposures; Nevertheless, the lack of availability of rabies biologics in endemic countries has been a long-standing issue. The absence of data on the burden of rabies and the lack of education reaching the general public and health professionals on rabies prevention measures have also contributed to the neglected status of the disease and the large number of potentially preventable deaths worldwide. Political will is crucial for any sustainable disease prevention program.