A global study on canine rabies has found 160 people die every day from the disease.
Even though the disease is preventable, the study says about 59,000 people die every year of rabies transmitted by dogs.
The multi-author study, by the Global Alliance for Rabies Control (GARC) partners for rabies prevention group, also shows annual economic losses because of the disease are about US$8.6bn (£5.7bn), mostly due to premature deaths, but also because of spending on human vaccines, lost income for victims of animal bites and other costs.
GARC executive director Louis Nel said the study was ground-breaking and an essential step towards improved control and eventual elimination of rabies.
“An understanding of the actual burden helps us determine and advocate for the resources needed to tackle this fatal disease,” Prof Nel said.
Led by Katie Hampson of the University of Glasgow, the study also considers the extent of control efforts in every country in the world.
Dr Hampson said: “The breadth of data used in this study – from surveillance reports, to epidemiological study data, to global vaccine sales figures – is far greater than analysed before, allowing this more detailed output.”
The study found, overwhelmingly, the greatest risk of canine rabies is in the poorest countries; the death rate (deaths/100,000 people) is highest in countries in sub-Saharan Africa, while India has the highest number of fatalities, with more than 20,000 human deaths annually.
The proportion of dogs vaccinated is far below that necessary to control the disease across almost all countries of Africa and Asia.
Rabies is close to 100% fatal, but it is also almost 100% preventable, and the best, most cost-effective way of preventing canine rabies is by vaccinating dogs. This needs to be supplemented by improving access to human vaccines.
According to the report, this one health approach to eliminating rabies deaths, with collaboration between the human and animal health sectors, can save many lives and significantly reduce the burden on vulnerable economies.
Indeed, the countries that have invested most in dog vaccination are the ones where human deaths from the disease have been virtually eliminated.
The study also emphasises reporting systems are fundamental to rabies elimination, to monitor and assess the success of prevention efforts.
“No one should die of rabies and GARC and its partners will continue to work together using a one health approach towards global rabies elimination,” Prof Nel said.