Legal mandates and policy basis
- Republic Act No. 9482 (the Anti-Rabies Act of 2007) supplies the legal mandate for control and elimination of human and animal rabies and for prescribing penalties and funding for violations.
- A Memorandum of Agreement among the Secretaries of the Department of Agriculture, Health, Education, Culture and Sport, and the Interior and Local Government dated May 8, 1991 guides collaborative implementation.
- Executive Order No. 84 declares March as the Rabies Awareness Month, rationalizes rabies control measures, and appropriates funds.
- Batas Pambansa Blg. 97 requires compulsory immunization of live stock, poultry, and other animals against dangerous communicable diseases.
- WHO Technical Report Series 931 supports guidance on rabies-free and rabies-free countries or areas.
- DOH Administrative Order No. 2005-0023 supports the Disease-Free Zone initiative for campaigns to eliminate diseases as public threats, including rabies.
- DOH Administrative Order No. 2007-0036 incorporates rabies under the Philippines Integrated Disease Surveillance and Response (PIDSR) Framework for immediately notifiable diseases/syndrome or event, including rabies.
Goals, objectives, and target outcomes
- The Order sets a goal to declare the Philippines as a Rabies-Free Country by 2020.
- The Order directs the declaration of provinces, cities, municipalities, and islands as rabies-free zones.
- The Order requires maintenance and sustainability of the rabies-free status of provinces, cities, municipalities, and islands already declared rabies-free.
- The Order requires identification of provinces, cities, municipalities, and islands eligible for rabies-free zone declaration.
- The Order mandates technical and logistic assistance to LGUs on how to achieve and maintain rabies-free zone/area status.
- The Order requires validation and confirmation of rabies-free status based on Department of Health and Department of Agriculture–Bureau of Animal Industry criteria.
Scope and coverage of who must comply
- The guidelines apply to all sectors, including public and private actors.
- The guidelines cover National Government Agencies (NGAs), Local Government Units (LGUs), local and international NGOs, and People’s Organizations (POs).
- The guidelines cover the community involved in prevention, control, and elimination of human and animal rabies.
Definitions used in declarations
- Animal birth control means managing animal populations through reproductive control measures such as neutering.
- Dog ecology means the study of the relationship of dogs to the environment, human population, and other dogs, including population density and behavior.
- Impounding means capturing and confining stray animals.
- Rabies-Free Zone/Area means an area with no confirmed human or animal rabies case, bats or indigenously acquired infection by a lyssavirus during the previous two (2) years, in the presence of an adequate surveillance system and import policy, and after satisfying all criteria for declaration.
- Provisional Rabies-Free Zone/Area means an area historically free of rabies where adequate surveillance is in place to confirm rabies-free status, an effective import policy is in place to maintain rabies-free status, and the area has not yet met other requirements for full rabies-free zone/area declaration.
- National Rabies Prevention and Control Program means the program implemented by the Department of Agriculture (DA) and Department of Health (DOH) in collaboration with the Department of Education, Department of Interior and Local Government, LGUs, NGOs, POs, and the academe, with the ultimate objective of controlling rabies in the country.
- Veterinary groups refers to animal health practitioners responsible for animal health and welfare.
- Dog bite means an act by which a dog seizes, cuts, and grips with its teeth its victim so that the victim’s skin is wounded, pierced, and scratched.
- Responsible Pet Ownership means providing rabies vaccinations at 3 months of age and every year thereafter, providing clean and proper shelter, providing enough exercise and proper nutrition, keeping pets within their backyard away from contact with infected dogs, keeping pets on leash when walked, and bringing pets for regular health consultation with a veterinarian.
Core declaration requirements and procedures
- Rabies is declared a notifiable disease, and LGUs must report human and animal rabies cases promptly.
- OIE and the World Health Organization require no indigenous acquired rabies infection confirmed in humans and any animal species during the past two (2) years.
- Declarations require an effective disease surveillance system for humans and animal rabies that is set up and well implemented in the province/city/municipality.
- Declarations require all regulatory measures for prevention and control of rabies, including shipping/transport procedures.
- Declarations require accessibility of post-exposure treatment using modern cell culture vaccines approved and recommended for both intradermal and inmtramuscular use.
- Declarations require an established mechanism to ensure availability of Human Anti-Rabies Vaccines and rabies immunoglobulins, including schemes such as inter-local health financing or cost sharing (public-private mix, patient-pet-owner).
- Declarations require regular health education and advocacy activities on rabies prevention and control, including integration into the Elementary School curriculum.
General requirements for a rabies-free zone/area declaration
- A rabies-free zone/area declaration requires a local ordinance on prevention and control of rabies.
- A rabies-free zone/area declaration requires a localized comprehensive Rabies Prevention/Control and Elimination Program.
- Animal rabies requirements require:
- No case of indigenously acquired infection by a type 1 lyssavirus confirmed in any animal species, including bats, at any time during the previous two (2) years, supported by monthly zero-case reporting from the Municipal Agriculture Office/Veterinary Office and monthly reporting of laboratory confirmed cases by the Philippine Animal Health Center (PAHC), Research Institute for Tropical Medicine (RITM), 10 Regional Animal Disease Diagnostic Laboratories (RADDLs), and 2 accredited provincial rabies laboratories.
- An existing comprehensive rabies vaccination program in place for 2 years under the Anti-Rabies Act of 2007 provisions.
- An adequate laboratory-based surveillance system in full operation, including:
- Functional rabies laboratories performing Fluorescent Antibody Test (FAT) for rabies diagnosis in a minimum of 0.02% of the estimated dog population in designated catchment areas/zones per year.
- A functional referral system for confirmation of cases in the region.
- An impounding facility/system for clinically suspect rabid dogs whether or not involved in a potential rabies exposure.
- Enforcement of control measures to eliminate, destroy, and dispose stray dogs as per existing ordinance.
- All animal rabies prevention and control components together with the animal birth control program in place.
- An effective Rabies Control Committee at all local government levels: province, city, municipality, and barangay.
- Effective dog movement control measures, requiring that dogs and cats for inter-island transport have a valid vaccination certificate and can be transported at least two (2) weeks after vaccination or have a valid rabies vaccination within the last 12 months, certified by a licensed veterinarian.
- An information, education, and communication campaign pursuing Responsible Pet Ownership in provinces, cities, municipalities, and barangays using print, broadcast, and other media, with billboards and streamers in strategic areas.
- Human rabies requirements require:
- No case of indigenously acquired infection by a lyssavirus confirmed in any human at any time during the previous two (2) years, supported by monthly zero-case reporting from the Municipal Health Office.
- An adequate surveillance system on rabies under the PIDSR, including:
- Functional referral for laboratory confirmation of human cases in the regions by FAT or other antigen detection procedures such as Polymerase Chain Reaction (PCR).
- Surveillance involving all levels—health centers, animal bite treatment centers, and hospitals—through sentinel or non-sentinel sites.
- Monthly reporting of human rabies, including zero-case reporting.
- At least one staff trained on rabies surveillance to investigate all reported human rabies suspects.
- Immediate case investigation of reported human rabies cases by the LGU, with technical assistance from the Provincial Health Office or Center for Health Development when the LGU lacks technical expertise.
- Declaration of an outbreak and immediate comprehensive response when a confirmed rabies case is reported in a declared rabies-free area.
- Post-Exposure Treatment readily accessible to all animal bite victims, with a mechanism ensuring availability of human anti-rabies vaccine and rabies immunoglobulin.
- Adequate health education, promotion, and advocacy on responsible pet ownership, proper animal bite wound care, and adherence to treatment protocol, including integration of rabies prevention and control into the Elementary Schools curriculum and annual celebration of Rabies Awareness Month.
Recovery process after incursions
- Incursions of rabies must be reported immediately, and investigation must be conducted with case confirmation.
- Control measures must be instituted immediately, including site-specific mass vaccination of dogs, surveillance, movement control, and information campaign.
- The rabies-free status must be re-evaluated 6 months after the last vaccination date by the National Rabies Prevention and Control Committee.
- Rabies-free status must be restored in writing by both the DA and DOH Secretaries.
Sustaining rabies-free zones operational duties
- The Governor and City/Municipal Mayors must take charge of implementation in their province/city/municipality and must allocate funds for procurement of vaccines for animals and humans.
- Barangay Officials must provide full support and cooperation to “Bantay Rabis Sa Barangay” headed by the Barangay Captain, who must manage entry of new dogs and maintain the registry of all dogs in the catchment area.
- Rabies Control Committees at the provincial/city/municipal level must oversee implementation of rabies control program components and assist in maintaining rabies-free zones.
- DA/DOH Regional Rabies Control Committees must supervise and assess rabies-free zone implementation in their areas.
- The Regional Animal Disease Diagnostic Laboratory (RADDL) of DA-Regional Field Units (DA-RFU) must continue routine animal surveillance, investigate occurrences of animal rabies, and provide monthly reports of animal rabies cases to the National Rabies Committee.
- Epidemiology and Surveillance units at municipal, city, provincial, and regional levels must operate continued human rabies surveillance under PIDSR, and the National Epidemiology Center must provide monthly reports of human rabies cases to the National Rabies Committee.
- DA-BAI and DOH must initiate program implementation activities, monitoring and evaluation, and declarations of rabies-free zones/areas using rabies-free zone parameters.
- DA-BAI and DOH must conduct joint periodic monitoring of rabies-free zones.
- DILG Regional/Provincial Directors must monitor compliance of Local Chief Executives and their mandated roles under the May 8, 1991 Memorandum of Agreement.
- DOH must provide human anti-rabies immunizing agents to Animal Bite Treatment Centers (ABTCs) through the CHDs, and provide pre-exposure treatment of high-risk groups such as health staff, animal handlers/vaccinators, veterinarians/diagnosticians, and children below 15 years of age in highly endemic areas.
- The Department of Education must assist in developing health information and education materials for school children.
- The RITM Rabies Laboratory must serve as the human rabies reference center for diagnosis using techniques including PCR, FAT, and MIT.
Repeal of conflicting prior rules
- The provisions of the National Rabies Prevention and Control Program Manual of Operation, National Rabies Committee (CY2001) are rescinded.
- All other issuances inconsistent with the Order are rescinded.