Sri Lanka takes action towards a target of zero rabies death by 2020.

Rabies is a 100% vaccine-preventable and 100% fatal zoonotic, viral disease. It is usually spread to humans by saliva, through bites or scratches. Dogs are the source of the vast majority of human deaths from rabies. Political will and leadership have been the main drivers for success of the Sri Lankan effort to reduce the burden of disease attributable to rabies. Post-exposure prophylaxis, which is available in government health facilities, at no cost, to all bite patients, has been a main axis of the rabies-elimination strategy. To attain the last mile in rabies elimination in Sri Lanka by 2020, more will need to be done to scale up dog vaccination, enforce responsible dog ownership, strengthen surveillance for animals and humans and conduct mass awareness programmes. Sri Lanka is the first country in the World Health Organization South-East Asia Region to develop a national strategy for elimination of dog-mediated rabies and is a key country in sharing knowledge, expertise and capacity-building in the region, towards a global target of zero rabies deaths by 2030.

Malaria elimination in Sri Lanka: what it would take to reach the goal.

Fifty years after narrowly missing the opportunity to eliminate malaria from Sri Lanka in the 1960s, the country has now interrupted malaria transmission and sustained this interruption for more than 12 months – no indigenous malaria cases have been reported since October 2012. This was achieved through a period overlapping with a 30-year separatist war in areas that were endemic for malaria. The challenge now, of sustaining a malaria-free country and preventing the reintroduction of malaria to Sri Lanka, is examined here in the context of rapid postwar developments in the country. Increased travel to and from the country to expand development projects, businesses and a booming tourist industry, and the influx of labour and refugees from neighbouring malarious countries combine with the continued presence of malaria vectors in formerly endemic areas, to make the country both receptive and vulnerable to the reintroduction of malaria. The absence of indigenous malaria has led to a loss of awareness among the medical profession, resulting in delayed diagnosis of malaria despite the availability of an extensive malaria diagnosis service. Highly prevalent vector-borne diseases such as dengue are competing for health-service resources. Interventions that are necessary at this critical time include sustaining a state-of-the-art surveillance and response system for malaria, and advocacy to maintain awareness among the medical profession and at high levels of government, sustained funding for the Anti-Malaria Campaign and for implementation research and technical guidance on elimination. The malaria-elimination effort should be supported by rigorous analyses to demonstrate the clear economic and health benefits of eliminating malaria, which exceed the cost of a surveillance and response system. An annual World Health Organization review of the programme may also be required.