Lessons learned from a pilot dog rabies vaccination model in Kinshasa and Kongo-Central, Democratic Republic of the Congo.

The Democratic Republic of the Congo (DRC) has set out a plan to eliminate dog-transmitted human rabies by 2033. The 50 million US dollar plan, 65 % of which is allocated to free vaccinations, has been difficult to fund. A study in three DRC sites (Mont-Ngafula in Kinshasa and Matadi and Muanda in Kongo-Central) aimed to explore an affordable, cost-effective local routine vaccination system. A survey was conducted in dog-owning households at each site regarding socioeconomic status, awareness of rabies and the characteristics and vaccination status of dogs. Then veterinary service accessibility, affordability and resources were assessed. Finally, a pilot of a routine vaccination service was implemented. Using R software, a logistic regression was performed to explore factors influencing rabies vaccination. Factors influencing vaccination included socio-economic status, dog characteristics, and the affordability of vaccinations. The cost of vaccinations (25-30 USD in Mont-Ngafula, 10-15 USD in Matadi, 7 USD in Muanda) was two to three times more expensive than owners considered affordable (7-9 USD, 1-5 USD, 2-6 USD). Geographical distribution of providers was poor and resources to vaccinate dogs routinely were inadequate. A pilot programme supplied vaccines and accessories to public veterinary services, expanding their geographic coverage by setting up temporary vaccination points and charging affordable costs (4 USD in Matadi and Muanda, and 5 USD in Mont-Ngafula). This increased adherence among dog owners, though the response varied between sites. The study offers useful insights into the key considerations for successfully implementing a cost-effective and affordable routine vaccination service at local level.