• Street dogs

Peru and Bolivia strengthen cooperation to tackle rabies

—May 2026 —

In Sucre, Bolivia, dogs are part of everyday life. They wander through markets and neighborhoods, following familiar routes from one block to the next. Many are not truly stray, they return home at night, where someone feeds them, and neighbors often watch over them.

Unlike feral dogs, which are typically avoided, these “community dogs”—common across many cities and villages in Latin America—are sometimes even clothed in sweaters during the winter months. Yet they belong to no one in particular.

This way of living alongside dogs is shaped by habit and culture, but it creates a challenge. Without a single owner responsible for each animal, rabies vaccination becomes uneven and difficult to track. In areas where this mortal disease persists, even a small number of unvaccinated dogs can allow the virus to continue circulating.

Rabies remains endemic in Bolivia and southern Peru. Over the past five years, both countries have reported more than 180 cases of canine rabies. Through the Cooperation Among Countries for Health Development (CCHD)—a project supported by the Pan American Health Organization (PAHO) and its specialized center, PANAFTOSA—the two countries are working together to strengthen detection, surveillance, prevention, and control.

Rabies is a zoonotic disease with a fatality rate of nearly 100%. It is estimated to cause around 59,000 deaths globally each year, about 40% of them in children under the age of 15. Between 2013 and 2022, 31 human deaths were reported in Bolivia, and over the past three years, only four cases have been notified.

“The dog that transmits rabies is the one that has contact with people—the one that comes and goes, in the streets with no formal owner,” explains Marco Vigilato, Advisor for Zoonotic Diseases and Veterinary Public Health at PAHO. “Risk perception is one of the biggest challenges. If people do not perceive the risk, they will not support vaccination services or report the death of a dog.”

Training activities
Training activities

A shared challenge

The project, implemented between 2024 and 2025, is an example of South–South cooperation, grounded in the idea that countries facing similar challenges can learn from one another. Through this partnership, Bolivia and Peru exchanged technical expertise in key areas like rabies surveillance, field methodologies, community outreach and laboratory diagnosis.

One of the project’s main outcomes was the joint development of two key tools: the rabies focus surveillance protocols and a canine population estimation methodology. These products were shaped by a series of technical exchange workshops including field activities held across Bolivia in La Paz, Sucre, and Cochabamba—as well as in border areas near Lake Titicaca.

Across the region, vaccination campaigns have often relied on outdated population estimates. In many cases, the actual number of dogs is significantly higher, meaning that even well-executed campaigns fail to reach the 80% coverage needed to interrupt transmission.

“Estimating the dog population is critical. Without it, we cannot accurately plan how many vaccines are needed or measure coverage,” according to Vigilato.

In Cochabamba in 2025, more than 60 professionals from national, departmental, and local levels from both countries worked to strengthen coordination, align approaches, and build a shared understanding of rabies surveillance standards. Participants also applied the methodology for estimating dog populations to improve planning and resource allocation.

Another key area of progress has been laboratory diagnosis. Through training and exchange, national laboratories in both countries have strengthened procedures, explored new methodologies, and improved the reliability of results.

“PCR testing is highly sensitive; samples must arrive in good condition to ensure consistent results. With our colleagues from Bolivia, we discussed how to identify alternatives to ensure the proper transport of samples,” explains Ricardo López, National Institute of Health of Peru.

Together, these efforts are improving rabies control—combining stronger vaccination campaigns with more timely and coordinated surveillance. With better data, health teams can plan more effectively, deploy brigades strategically, and prioritize high-risk areas. Updated outbreak response guidelines are also helping ensure faster, more coordinated action when cases are detected.

“Our countries may have different systems, but we share borders and we must work together and consider the nature of these diseases, interaction and cooperation to implement effective public health policies,” explains Walter Oporto, Peru’s Regional Health Manager in the department of Arequipa.

First test: a rabies case in Sucre

In October 2025, public health officials in Bolivia had their first opportunity to apply these tools in practice. Working alongside Peruvian counterparts, local, municipal, and departmental teams coordinated health brigades to respond to a human case of rabies—an approach that would later serve as a model across the country.

Equipped with vaccines, clipboards, and simple tools to safely restrain animals, teams moved street by street—knocking on doors, stopping passersby, and scanning alleys for dogs.

“Our group included more than 50 workers, and we carried out a large-scale response, reaching even the most distant neighborhoods. Many dogs and cats were vaccinated,” explains Patricia Ledezma, a veterinarian supporting outbreak control efforts.

The mission was simple, but urgent: find every animal, identify every possible exposure, and stop the virus before it spreads. Rabies is always fatal once symptoms appear.

At each home, brigades asked the same questions: Are there dogs here, and are they vaccinated? Has anyone been bitten? Unvaccinated animals were vaccinated on the spot. Records were completed, and colored collars were tied to identify protected animals. Community dogs in the streets were carefully captured and vaccinated.

“These pets go to many places, and we need to be more careful. Rabies vaccines are essential, and with the municipality’s support we can reach many more animals,” explains Omar Salazar. 

Dog receives vaccination
Activity to reach out to the community and vaccinate dogs

Eliminating human rabies transmitted by dogs

In 2023, more than 45 million dogs were vaccinated across the Americas through public campaigns. This progress reflects increased awareness and expanded access to care for people exposed to the virus.

As a result, the Region has achieved a 98% reduction in human rabies transmitted by dogs, from 300 cases in 1983 to just 10 in 2025. This progress supports PAHO’s Elimination Initiative, which aims to eliminate more than 30 communicable diseases and related conditions by 2030.

Outreach
Family who brought their pets to be vaccinated