Why it's still a threat
Canine rabies is a forgotten disease of the poor, where nobody survives to tell the tale. The lack of disease diagnosis and reporting prevents rabies becoming a higher priority disease.
Only 54% of survey respondents in urban slums in India knew that rabies is a deadly disease. Only 30% of Ethiopian respondents believed that immediate care of bites was important in preventing rabies. A key factor in preventing the spread of rabies in endemic countries is education.
Post-bite vaccines are not always available to bite victims in resource-poor regions where they are most needed. The average cost of post-exposure treatment in Africa is around $40, and in Asia it's $49. Given that the average daily income in these countries is $1-$2, that expense can be nearly impossible for families to cover.
Prevention methods fall short.
Vaccinating at least 70% of dogs can eliminate human rabies deaths, and low immunisation results (50%) can still provide a reasonable chance to control the disease. Inhumane mass killing of dogs, though widely prevalent, does nothing to halt the spread of rabies, and can even worsen the problem.
An ancient disease first documented in Babylon, 2300 B.C., rabies has one of the highest fatality rates of all infectious diseases. Once an individual shows symptoms, it is considered to be 99.9% fatal.
But it doesn't have to be this way. In fact, in the United States and many countries in Europe, effective policies and funding have led to the complete elimination of dog rabies. But elimination of dog rabies in these countries has also led to a lack of prioritisation for funding and support to eliminate the disease across the world.