Rabies is a neglected but preventable zoonotic disease that predominantly affects the most vulnerable populations living in remote rural areas of resource-limited countries. To date, every country on the African mainland is considered endemic for dog-mediated rabies with an estimated 21′500 human rabies deaths occurring each year. In 2018, the United Against Rabies collaboration launched the Global Strategic Plan to end human deaths from dog-mediated rabies by 2030. The epidemiology of rabies from most Western and Central African countries remains poorly defined, making it difficult to assess the overall rabies situation and progress towards the 2030 goal.

In this review, we attempt to provide an overview of the current rabies situation in 22 West and Central African countries based on published scientific literature and information obtained from rabies focal points. To this end, information was collected on i) established surveillance, ii) diagnostic capacity, iii) post-exposure prophylaxis (PEP) availability and coverage, iv) dog population estimates, v) dog vaccination campaigns, vi) animal and human health communication (One Health), vii) molecular studies, viii) Knowledge, Attitude and Practices (KAP), ix) cost estimates and x) national control strategies.

Although rabies is a notifiable disease in the majority of the studied countries, national surveillance systems do not adequately capture the disease. A general lack of rabies diagnostic capacity has an additional negative impact on rabies surveillance and attempts to estimate rabies burden. Recurrent shortages of human rabies vaccine are reported by all of the countries, with vaccine availability usually limited to major urban centers but no country has yet adopted the new WHO-recommended 1-week intradermal vaccination regimen. Most countries carry out subsidized mass dog vaccination campaigns on World Rabies Day. Such activities are indispensable to keep rabies in the public consciousness but are not of the scale and intensity that is required to eliminate rabies from the dog population. Countries will need to scale up the intensity of their campaigns, if they are to progress towards the 2030 goal. But more than half of the countries do not yet have reliable figures on their dog populations. Only two countries reached stage 2 on the Stepwise Approach towards Rabies Elimination ladder – indicating that their national governments have truly prioritized rabies elimination and are thus providing the necessary support and political buy-in required to achieve success.

In summary, the sub-region of West and Central Africa seems to be divided into countries which have accepted the challenge to eliminate rabies with governments committed to pushing forward rabies elimination, while other countries have achieved some progress, but elimination efforts remain stuck due to lacking government commitment and financial constraints. The possibility to meet the 2030 goal without international solidarity is low, because more than two-thirds of the countries rank in the low human development group (HDI ≤ 152). Leading countries should act as role models, sharing their experiences and capacities so that no country is left behind. Unified and with international support it is possible to reach the common goal of zero human rabies deaths by 2030.

狂犬病是一种被忽视但可预防的人畜共患病，主要影响生活在资源有限国家偏远农村地区的最脆弱人群。迄今为止，非洲大陆的每个国家都被认为是犬介导的狂犬病流行，每年估计有 21,500 人死于狂犬病。2018 年，联合抗击狂犬病合作启动了到 2030 年结束人类因狗介导的狂犬病死亡的全球战略计划。 大多数西非和中非国家的狂犬病流行病学仍不明确，难以评估总体狂犬病情况和2030 年目标的进展。

在这篇综述中，我们试图根据已发表的科学文献和从狂犬病联络点获得的信息，概述 22 个西非和中非国家的当前狂犬病情况。为此，收集了以下信息：i) 已建立的监测，ii) 诊断能力，iii) 暴露后预防 (PEP) 的可用性和覆盖率，iv) 犬只数量估计，v) 犬只疫苗接种运动，vi) 动物和人类健康交流(One Health)，vii) 分子研究，viii) 知识、态度和实践 (KAP)，ix) 成本估算和 x) 国家控制战略。

尽管狂犬病在大多数研究国家是一种应通报的疾病，但国家监测系统并没有充分捕捉到这种疾病。狂犬病诊断能力的普遍缺乏对狂犬病监测和估计狂犬病负担的尝试产生了额外的负面影响。所有国家都报告人用狂犬病疫苗反复短缺，疫苗供应通常仅限于主要城市中心，但尚无国家采用新的世卫组织推荐的 1 周皮内接种方案。大多数国家在世界狂犬病日开展有补贴的大规模犬类疫苗接种活动。此类活动对于保持公众对狂犬病的认识是必不可少的，但其规模和强度不足以从犬群中消除狂犬病。各国要想朝着 2030 年的目标前进，就需要加大宣传力度。但是，超过一半的国家还没有关于其犬类数量的可靠数据。只有两个国家达到了逐步消除狂犬病阶梯的第 2 阶段——这表明它们的国家政府真正将消除狂犬病列为优先事项，因此正在提供取得成功所需的必要支持和政治支持。

综上所述，西非和中非次区域似乎被划分为接受消除狂犬病挑战的国家，政府致力于推动消除狂犬病，而其他国家也取得了一些进展，但消除工作仍然停滞不前。缺乏政府承诺和财政限制。如果没有国际团结，实现 2030 年目标的可能性很小，因为三分之二以上的国家属于低人类发展水平（HDI ≤ 152）。领先国家应发挥榜样作用，分享经验和能力，不让任何国家掉队。在国际支持下，到 2030 年实现人类狂犬病零死亡的共同目标是可能的。