BACKGROUND: Rabies is a neglected disease, primarily due to poor detection stemming from limited surveillance and diagnostic capabilities in most countries. As a result, there is limited ability to monitor and evaluate country, regional, and global progress towards the WHO goal of eliminating human rabies deaths by 2030. There is a need for a low-cost, readily reproducible method of estimating rabies burden and elimination capacity in endemic countries. METHODS: Publicly available economic, environmental, political, social, public health, and One Health indicators were evaluated to identify variables with strong correlation to country-level rabies burden estimates. A novel index was developed to estimate infrastructural rabies elimination capacity and annual case-burden for dog-mediated rabies virus variant (DMRVV) endemic countries. FINDINGS: Five country-level indicators with superior explanatory value represent the novel "STOP-R index:" (1) literacy rate, (2) infant mortality rate, (3) electricity access, (4) political stability, and (5) presence/severity of natural hazards. Based on the STOP-R index, 40,111 (95% CI 25,854-74,344) global human rabies deaths are estimated to occur in 2022 among DMRVV-endemic countries and are projected to decrease to 32,349 (95% CI 21,110-57,019) in 2030. INTERPRETATION: The STOP-R index offers a unique means of addressing the data gap and monitoring progress towards eliminating dog-mediated human rabies deaths. Results presented here suggest that factors external to rabies programs influence the successes of rabies elimination, and it is now possible to identify countries exceeding or lagging in expected rabies control and elimination progress based on country infrastructure.

Summary box | Risk communication and community engagement (RCCE) operations is a novel approach in public health emergency readiness. | RCCE should be integrated into every phase (preparedness, response, recovery and mitigation) of the emergency management cycle. | RCCE is critical in every public health emergency and must be operationalised in public health programmes to ensure effective response measures.

Since the very beginning of the HIV epidemic, sex workers have been at increased risk for HIV, because of multiple partners, and highly vulnerable because of environmental and structural barriers that prevent them from accessing services or having control over their activities.1 Experience with feasible and effective prevention programmes has been accumulating for more than 20 years. In Democratic Republic of Congo,2 Côte d'Ivoire3 and Bolivia,4 HIV and or STI rates among sex workers declined as a result of individual interventions including condom promotion, STI care and risk-reduction messages. Experience from the Dominican Republic5 and India6 7 illustrated the effectiveness of contextual interventions to reduce the vulnerability of sex workers and create an enabling environment. | So far, large-scale implementation of sex-worker interventions to reduce either risks or vulnerability has lagged behind. Most countries today still do not have a national plan to address the needs for this population, and worldwide less than 50% of sex workers have access to a minimum of prevention services.1 8 India is clearly an exception!

The Asian tsunami, of December 2004, caused widespread loss of life. A series of surveys were conducted to assess tsunami-related mortality and injury, risk factors, care seeking and injury outcomes. Three surveys of tsunami-affected populations, in seven districts of Aceh province, were conducted between March and August 2005. Surveys employed a two-stage cluster design and probability proportional to size sampling methods. Overall, 17.7% (95% confidence interval (CI)=16.8-18.6) of the population was reported as dead/missing1 and 8.5% (95% CI=7.9-9.2) had been injured. Odds of mortality were 1.41% (95% CI=1.27-1.58) times greater in females than in males; risk of injury was opposite, with an odds of injury of 0.81 (95% CI=0.61-0.96) for females in comparison to males. Mortality was greatest among the oldest and young population sub-groups, and injuries were most prevalent among middle-aged populations (20-49). An estimated 25,572 people were injured and 3682 (1.2%) suffered lasting disabilities. While mortality was particularly elevated among females and among the youngest and oldest age groups, injury rates were the greatest among males and the working-age population, suggesting that those are more likely to survive the tsunami were also more likely to be injured.

In February 2006, a diagnosis of sylvatic epidemic typhus in a counselor at a wilderness camp in Pennsylvania prompted a retrospective investigation. From January 2004 through January 2006, 3 more cases were identified. All had been counselors at the camp and had experienced febrile illness with myalgia, chills, and sweats; 2 had been hospitalized. All patients had slept in the same cabin and reported having seen and heard flying squirrels inside the wall adjacent to their bed. Serum from each patient had evidence of infection with Rickettsia prowazekii. Analysis of blood and tissue from 14 southern flying squirrels trapped in the woodlands around the cabin indicated that 71% were infected with R. prowazekii. Education and control measures to exclude flying squirrels from housing are essential to reduce the likelihood of sylvatic epidemic typhus.