Costs of the current rabies control strategies on Flores Island

Rabies is a zoonotic disease and always fatal once clinical signs appear in human. The disease transmits to humans through an animal bite. Dogs are the main vector of rabies in humans on Flores island, Indonesia, resulting in about 19 deaths annually. Therefore, it is necessary to control the disease. Currently, the rabies control program at Flores island includes post exposure treatment of humans, mass vaccination and culling of dogs, and surveillance in dogs. Although the program has been in place for several years, it seems that rabies is not yet controlled. Therefore, an evaluation of the program is needed. The objective of this study is to estimate the net costs of the current control program of rabies on Flores island. A deterministic economic model has been developed to calculate the net costs of the rabies control program and of the individual components from the year 2000-2011. Data from the Health Department and Husbandry Department of East Nusa Tenggara Province were used as inputs. The result shows that the annual net costs due to vaccination, culling of dogs and surveillance (prevention) were calculated to be respectively $US 90,420 (Rp 809.71 million), $US 2,670 (Rp 23.9 million) and $US 4,755 (Rp 42.6 million). The annual net costs of the post exposure treatment in humans (cure) was estimated to be $US 172,389 (Rp 1.5 billion). Summarizing, the annual costs involved in the rabies control program add up to $US 270,234 (Rp 2,4 billion) in total, with the post exposure treatment program being the most expensive component. The preventive measures do not seem to be effective, but the amount of money spent in prevention is lower than the amount of money spent in cure. This means that an improved control of Rabies might become cost-effecitve