Organic waste mismanagement, free-roaming dog ecology, and rabies risk in endemic countries: a one health narrative review

1 Introduction

Rabies is known as a fatal enzootic disease with a complex epidemiology (1). Dog-mediated rabies has become a major public health problem in developing countries of Asia and Africa. As the global population of free-roaming domestic dogs grows, there is increasing concern about impacts on human health and wildlife conservation (2). Thus, effective management of dog populations is very important and requires reliable information on their diet, feeding behavior, and social ecology (3).

According to the recent estimates, more than 95% of human rabies deaths occur in Asia and Africa (4). Usually, children are the most frequent victims of animal bites, with boys aged 3 months to 9 years having the highest incidence (5). Males were more frequently affected by dog bites than females, whereas females were comparatively more often affected by cat bites (6). However, rabies can be controlled and eventually eliminated through coordinated prevention and control measures. Thus, the United Nations has recognized the importance of the One Health approach, and together with the Tripartite partners, has strengthened collaborative efforts to facilitate the progress toward the Sustainable Development Goals (SDGs) by working closely to end dog-mediated rabies (7). There is also a need to understand the core competencies of the One Health approach including the environment, human health, animal health, and social dimensions.

Developing countries also lack the stable resources and infrastructure needed to support economic development and improve living standards (8). Therefore, a balance between socioeconomic development and environmental integrity is needed, which comes mainly from sustainable ecosystems and agricultural practices. This balance may be undermined by political, economic, and financial constraints that also contribute to inadequate environmental sanitation (9). Hence, such conditions may increase opportunities for the transmission of zoonotic pathogens among humans, domestic animals, and wildlife (10, 11). Socio-economic risk factors, human activities, social practices, infrastructure development and rapid urbanization also increase the complexity and transmission risks associated with known and unknown zoonotic diseases (12).

Since the One Health approach recognizes that the health of animals and humans is linked to the environment in which they live, people living in underserved or environmentally degraded settings will have a higher rate of disease, morbidity and mortality than those living in environmentally sound conditions (13). There is a close relationship between human and environmental risk factors that sustain dog-mediated rabies transmission, particularly in impoverished and inadequately serviced communities of Asia and Africa (2). Various ecological or environmental variables that may play a role in the spread of dog-mediated rabies include changes in human population density and distribution, seasonal fluctuations in temperature, vegetation, livestock distribution, poorly regulated husbandry practices, water bodies, and the disposal of waste in open public spaces (14, 15).

Food and organic waste from households, commercial establishments, agriculture, the food industry, markets, and slaughterhouses represent critical but often neglected environmental drivers of free-roaming dog populations. In rabies-endemic settings where free-roaming dog populations persist, evidence suggests that inefficient municipal waste management, rapid urbanization, and inadequate waste collection lead to the accumulation of edible waste on streets, and in open dumps, markets, landfills, and residential areas, where it serves as an important food source for free-roaming dogs. Mismanaged waste may support free-roaming dog populations by providing routine access to food, thereby potentially undermining humane dog population control or rabies control programs (16).

Similarly, urban organic waste can enhance the human–animal interface by bringing free-roaming dogs and other scavenging species to urban and peri-urban environments, where they have opportunities to interact with humans, thereby potentially increasing opportunities for dog bites, interspecies contact, and exposure to rabies (13). Differences in the availability and composition of waste may reflect community lifestyles, local infrastructure, urbanization, and waste-management capacity, which may affect dog feeding behavior, aggregation around waste sites, movement through human settlements, and interactions with humans and other animals. Although organic waste does not directly transmit rabies, existing data suggest that it may indirectly contribute to rabies risk by supporting dog aggregation, increasing opportunities for human–dog contact, and complicating integrated One Health interventions involving mass dog vaccination, dog population control, responsible ownership, community education, and public health surveillance.

It is crucial to understand these environmental dynamics to provide evidence for designing integrated rabies-prevention strategies that combine waste management and humane dog population control, mass dog vaccination, humane dog ownership, community education, and multisectoral action across the municipal, veterinary, public health, and environmental sectors. This narrative review summarizes the existing evidence on the interaction between organic waste management for free-roaming dogs and rabies transmission ecology, identifying pertinent environmental, social, and health factors to inform targeted interventions in rabies-endemic developing countries. Figure 1 summarizes the proposed One Health pathway connecting organic waste mismanagement, free-roaming dog ecology, and human–dog interactions with rabies risk.

2 Methodology

2.1 Review design

This study aimed to synthesize information on the importance of mismanagement of organic waste as a free-roaming dog problem in rabies-endemic countries through a narrative review. The Review emphasized the potential environmental, animal health, public health, and One Health connections between organic waste, domestic waste, food waste, and waste from municipal solid waste sources and the ecology of free-roaming dogs and the risk of rabies transmission. The Review was intended to outline the availability of waste as a food and shelter resource for free-roaming dogs; the relationship between waste and free-roaming dog density, movement, behavior, and human–dog interactions; the potential relevance of waste to dog bites and rabies transmission; the environmental, social, and behavioral factors that support access to waste; and the role of waste management in neglected integrated rabies prevention and dog population management.

2.2 Literature search strategy

A structured literature search was conducted in PubMed, Scopus, and Web of Science on 24 July 2026. The search covered English-language literature published between 2010 and 2026. Search terms were developed around three main concepts: free-roaming dogs, rabies and related public-health outcomes, and organic waste or environmental resources. Relevant synonyms were combined using Boolean operators. The general search framework included terms such as “free-roaming dogs”, “stray dogs”, “free-ranging dogs”, “rabies”, “dog-mediated rabies”, “zoonotic diseases”, “organic waste”, “food waste”, “household waste”, “municipal solid waste”, “environment”, “waste management”, “One Health”, and “public health”. The complete database-specific search strategies for PubMed, Scopus, and Web of Science are provided in Supplementary Table 1.

2.3 Eligibility criteria

Studies that focused on the link between free-roaming dogs and organic waste, household waste, food waste, or municipal solid waste were considered relevant. Studies reporting dog density and abundance, movement, feeding behavior, aggregation, spatial distribution, and ecology in relation to environmental factors were all acceptable. The review focused on evidence from rabies-endemic countries, particularly in Asia and Africa. The main narrative synthesis included only peer-reviewed primary research articles, peer-reviewed review articles, and peer-reviewed case studies published in English from 2010 to 2026. Studies that did not focus on dogs, rabies, organic waste, waste management, environmental drivers, or free-roaming dog ecology were excluded. Studies that were limited to pets and confined dogs and had no relevance to free-roaming dogs were excluded. No consideration was given to non-English language publications. The main narrative synthesis did not include grey literature or non-peer-reviewed literature, such as policy documents, technical reports, theses, dissertations, conference abstracts, news reports, editorials, letters, or commentaries. However, selected authoritative or contextual sources were used where necessary to provide background information, describe established rabies-control principles, or support the interpretation of the findings.

2.4 Literature selection

The database searches retrieved 5,129 records, including 762 from PubMed, 2,434 from Scopus, and 1,933 from Web of Science. After removing duplicate records and applying the publication-year and language restrictions, 2,271 records remained for relevance assessment. The titles, abstracts, and, where necessary, full texts were reviewed according to the predefined eligibility criteria. Studies that contributed directly to the objectives and thematic scope of the review were retained. Additional sources were used selectively to provide background information, conceptual context, methodological guidance, or supporting information on rabies control and One Health. These supplementary sources were not included in the formal data extraction or thematic synthesis and were not counted among the 50 included studies. A total of 50 studies were included in the final narrative synthesis. Because this was a narrative review rather than a systematic review, the selection process was used to identify the most relevant and informative literature rather than to provide an exhaustive systematic assessment of all available evidence.

2.5 Data extraction and thematic organization

Each of the included studies was analyzed using a structured framework, consistent with the review objectives, to extract relevant information. Data extraction was performed independently by two reviewers using a standardized data-extraction form. Any discrepancies were resolved through discussion and consensus. The information extracted included country/region, study design, type of organic waste, source of organic waste, condition of waste management, characteristics of the free-roaming dog population, dog density, aggregation, movement, feeding and scavenging behavior, human–dog interactions, occurrence of dog bites, relevance of rabies, limitations in surveillance and control, and reported or proposed interventions. The extracted evidence was presented in analytical themes instead of country-based summaries. These themes encompassed organic waste access, dog aggregation, effects of waste availability on free-roaming dog ecology and population dynamics, human behaviors and social practices supporting food access, dog population management and rabies-control infrastructure, gaps in surveillance and intersectoral coordination, evidence for integrated One Health interventions, and gaps in evidence. Where appropriate within each theme, country-level findings were included to highlight commonalities, variations between settings, and challenges specific to each setting.

2.6 Thematic narrative synthesis

A thematic narrative synthesis was performed to integrate and interpret findings across countries, environmental settings, waste sources, dog-population characteristics, and public-health contexts. Within each theme, the evidence was compared to identify patterns, discrepancies, influences, and variations in the quality and definitiveness of evidence. The synthesis explored the potential pathway by which accessible organic waste can serve as a source of food and shelter, promote dog survival and aggregation, impact movement and population persistence, and enhance opportunities for dog–dog and human–dog interactions. It also considered the potential indirect role these environmental and ecological factors can play in dog-bite risk, rabies exposure, and challenges to vaccinations, dog surveillance, and humane dog population management. Thematic comparisons have been used to illustrate country examples, not to rank countries or to provide individual national summaries. Findings with quantitative or directly observed evidence were emphasized, and indirect associations, community perceptions, and proposed interventions were interpreted with caution. Given the great variation in the design of the studies included, geographical location of the studies, measurement of exposure, definition of the dog population, and reported outcomes, statistical pooling was not considered appropriate. The findings were then synthesized to identify commonalities, local nuances, evidence of interventions, methodological gaps, and areas for future research and practice in the field of One Health.

3 Organic waste generation and mismanagement as an environmental driver of free-roaming dog aggregation

Organic waste is a major anthropogenic food source for free-roaming dogs, primarily found in households, restaurants, hotels, markets, butcher shops, slaughterhouses, open bins, and landfills. Open garbage dumps are especially relevant because they contain fermentable organic household and sanitation-related waste, which can repeatedly attract dogs to the same places (17). Although these resources are readily available and energy-rich, they can contribute to localized dog aggregation, most likely in cities and peri-urban areas where waste collection and disposal are poor.

There is evidence in urban, peri-urban, and rural areas that human resources, such as domestic refuse, market waste, restaurant waste, slaughterhouse waste, butcher-shop offal, and open dumps, can provide predictable feeding and aggregation areas for free-roaming dogs. This has been reported in India, Pakistan, Bangladesh, Lebanon, Cameroon, and Sri Lanka, with varying degrees of evidence in different settings (14, 18–23).

Studies from different settings support the role of organic waste in shaping free-roaming dog presence and aggregation. In The Gambia, the amount and type of slaughterhouse waste affected dog presence and feeding behavior, and scavenger competition, especially where open access to waste was permitted due to poor fencing (24). Likewise, large garbage dumps in Mexico have served as stable food subsidies and supported high-density areas of free-roaming dogs that aggregated in specific areas (25). In India, predictors of free-roaming dog presence have also been linked to household waste, garbage piles, bakeries, restaurants, butcher and fish shops, and roadside food resources (26).

Improperly managed waste, such as inefficient collection, open dumping, uncovered or overflowing waste disposal points, irregular waste disposal, and mismanagement of public food sources, can increase dogs’ access to organic waste. Municipal solid waste systems in many developing settings primarily focus on collection and dumping rather than treatment, segregation, or safe disposal, resulting in edible waste piling up in streets, markets, drains, and open public areas. These circumstances can establish predictable feeding locations that sustain multiple dog visits and local clustering (16, 27).

The relationship between organic waste and dog aggregation may depend on settlement types and season. The distribution of free-roaming dogs in Delhi was explained by anthropogenic food availability, particularly feeding stations and garbage points; however, dog pack density was more strongly related to predictable feeding infrastructure than to incidental waste alone (28). In Arequipa, Peru, urban water channels collect rubbish during the dry season and serve as movement and foraging corridors for free-roaming dogs, indicating that drainage systems and seasonal dynamics can shape dog movement and contact patterns (29). These results suggest that organic waste mismanagement may generate temporally and spatially predictable resources that enable free-roaming dogs to aggregate and increase opportunities for contact, both of which are important for rabies transmission. Figure 2 illustrates the ecological pathway that connects garbage accumulation to the attraction of free-roaming animals, inter-animal interactions, and the potential for them to injure one another and transmit pathogens.

4 Effects of organic waste on free-roaming dog ecology and population dynamics

Accessible organic waste can indirectly affect free-roaming dog population dynamics by serving as a predictable anthropogenic food subsidy. Free-roaming dogs often feed at domestic and market garbage dumps, and food waste has been highlighted as a key driver of dog populations across a range of ecological contexts, including Nepal, India, Thailand, and Pakistan (2, 19). Documented dog population management programs have increasingly included improved waste management initiatives, underscoring their role as an adjunct intervention to minimize dog aggregation and population pressure (30).

The most well-defined quantitative data is from Delhi, where garbage points and intentional feeding stations were correlated with dog density, pack size, spatial distribution, and an estimated environmental carrying capacity of about 1.6 million dogs (28). Additionally, evidence from African settings suggests that anthropogenic food resources may be responsible for dog body conditions and population persistence. Human feces were detected in 56% of the dog scats examined in rural Zimbabwe, accounting for approximately 21% of the mass of items observed in the scats. In Western Kenya, 97% of dogs were reportedly scavenging household leftovers (3, 31).

These findings indicate that repeated use of energy-rich organic resources may benefit the survival, body condition, local persistence, and ecological carrying capacity of dogs. Scattered household waste, bakeries, garbage piles, restaurants, butcher shops, and roadside food sources have also been correlated with the presence, density, and spatial distribution of free-roaming dogs, which may provide more opportunities for human–dog contact and rabies exposure (26). Further evidence of resource distribution indicates that the abundance and spatial distribution of food resources could influence dog density and territory use. However, the response of group size may differ in different contexts and seasons (32).

Waste sites may also act as local aggregation spots where free-roaming dogs congregate for food, rest, and shelter. These aggregations can increase contact between dogs, competition for food, territoriality, and movement through human-dominated areas. Studies in Delhi and Brazil suggest that predictable feeding places, community feeders, commercial food stalls, and urban-organized waste are important predictors of cluster, pack size, and activity-pattern dispersal (28, 33). Dog clusters at waste sites are another factor that could challenge vaccination campaigns and One Health interventions while providing opportunities for human–dog conflict and disease exposure (34).

Although mass dog vaccination, sterilization, and responsible ownership remain foundational to rabies control, restricting access to organic waste may supplement vaccination strategies by lessening food availability, reducing dog congregation, and limiting contact opportunities (35). However, direct causal data linking any changes in waste levels, dog density, dog bite incidence, or rabies transmission are limited. Longitudinal and geospatial studies are warranted to quantify the extent to which changes in waste availability impact dog population dynamics and rabies-related outcomes (33).

5 Human behaviors and social practices maintaining food access for free-roaming dogs

Access to organic waste by free-roaming dogs is influenced by human behavior, either directly or indirectly. Unintentional feeding occurs when households, restaurants, markets, slaughterhouses, and food vendors dispose of food waste in open or inadequately covered areas, thereby providing an endless supply of free food for free-roaming dogs. In Arequipa, Peru, COVID-19-related restrictions reduced waste availability, and this effect was associated with changes in free-roaming dog populations, indicating that human-type food waste can affect dog abundance and distribution (36). In India, socioeconomic conditions, partial ownership practices, and urban waste-management behaviors have also been linked with the spatial aggregation of free-roaming dogs around food sources (26).

Intentional feeding is another key behavioral pathway that maintains free-roaming dog populations. Feeding may be based on compassion, cultural, religious, and ethical values regarding animal welfare. The presence of free-roaming dogs through intentional feeding is associated with community concerns about noise, scavenging, and rabies exposure in Thailand (37). Likewise, good-natured people, pedestrians, and non-professional animal caretakers might feed street dogs in public places, which may support dog survival but could also enhance local dog aggregation and human–dog contact if feeding occurs close to roads, schools, markets, hospitals, or residential waste sites (38, 39).

Therefore, informal caregivers play a complex role. Nevertheless, informal caregivers can also play a positive role by feeding dogs, detecting sick animals, actively participating in vaccination and sterilization programs, and improving animal welfare (40). Conversely, poorly managed garbage feeding may inadvertently intensify clustering, territoriality, scavenging behavior, and dog-bite risks, especially if feeding occurs near public areas or among unmanaged waste sites (38). The findings suggest that such caregiver involvement may not be discouraged. However, they should be channeled through best practices in safe feeding, vaccination support, sterilization, and cooperation with local veterinary and municipal authorities.

Another important behavioral aspect that maintains free-roaming dog populations and increases their reliance on organic waste in public environments is irresponsible dog ownership (41). Owned dogs that are poorly confined, unguarded, unvaccinated, and unsterilized may lead to the free-roaming population as scavengers from household waste, markets, and open dumps (38). Demonstrating the potential for declines in both free-roaming dog density and rabies cases through Catch-Neuter-Vaccinate-Return (CNVR) interventions in Greater Bangkok, the contribution of abandoned, lost, and poorly supervised-owned dogs underscores the need for responsible ownership within integrated dog population management (35).

Waste management, humane dog population control, and rabies control interventions also depend on community perception for acceptance and effectiveness. Although pet owners are probably aware that rabies is a fatal disease, self-efficacy, animal-keeping purpose, access to vaccine, and perceived responsibility are greater predictors of rabies vaccine response than risk perception (42). Evidence from Uganda further shows that dogs that roam freely may also evoke negative attitudes from communities due to potential dog bites, rabies risk, nuisance, and welfare concerns (43). These mixed views highlight that rabies-control strategies should balance public safety, animal welfare, and community acceptability.

Therefore, effective interventions should include responsible ownership, proper feeding habits, vaccinations, sterilization, awareness of waste management, and public education. International guidelines include the humane, socially feasible, and sustainable management of dog populations including vaccination, sterilization, responsible ownership, environmental management, and reduction of access to food and shelter (44). Culturally and community-supported education, vaccination, sterilization, and improved garbage management can work alongside rabies control, as demonstrated by the SARAH program in Sikkim (45).

6 Rabies-control infrastructure and dog population management

The effectiveness of rabies control in endemic areas requires the ability to vaccinate an adequate percentage of the dog population, to control the free-roaming dog population humanely, to educate and encourage responsible dog ownership, and to provide prompt post-exposure prophylaxis for humans exposed to dogs. However, these are challenging to enforce in areas where dogs are mobile, poorly registered, partially owned, and fed through waste and informal feeding. A review of country examples showed significant differences in control infrastructure, vaccination coverage, population-management capacity, and access to human rabies prevention (46–48).

Rabies is not directly transmitted through organic waste. Its public-health relevance is its potential to maintain free-roaming dog populations, encourage aggregation, and provide greater opportunities for dog–dog and human–dog interaction around households, markets, streets, schools, water bodies, slaughter sites, and open dumps. This indirect route could be especially significant when vaccination and human management of dogs are limited, as is bite surveillance and post-exposure prophylaxis. Environmental food access was associated with reported human exposure pathways in Cameroon, where open domestic feeding and the presence of garbage-associated stray dogs were associated with reported human rabies risk (22).

While mass dog vaccination is the key intervention to interrupt transmission of rabies by dogs, it requires accurate estimates of dog abundance and maintaining high coverage of dog populations. A large-scale vaccination program in Bangladesh is an example of vaccination using dog population estimates. Reportedly, more than 80% of the estimated number of dogs were vaccinated during national campaigns, and human-to-dog ratios and dog-density estimates were used to plan and monitor campaigns (47). However, the high percentage of free-roaming dogs in urban and peri-urban areas, with a significant unknown proportion, suggests that repeated enumeration and targeted vaccination are required to achieve adequate coverage (49).

The Philippines is also a good example of the importance of a coordinated infrastructure for vaccination. The Bohol Rabies Prevention and Elimination Project (BRP) provided a combination of dog population survey, dog registration, mass vaccination, animal-bite treatment services, diagnostic strengthening, school-based education, and bite management, which resulted in an increase in vaccination coverage from 44% in 2007 to 70% in 2008. From October 2008 to November 2010, there were no human or animal rabies cases diagnosed, which illustrates the potential benefits of coordinated and sustained implementation (48). Findings from other Philippine contexts also highlight the need to include puppies in vaccination programs, as they can significantly contribute to human rabies exposure and are often not targeted in vaccination campaigns (50, 51).

However, the control of rabies is still hampered by low vaccination rates and the free movement of dogs in some situations. In rural Guangxi, China, only 19.1% of dog-owning households reported vaccinating their dogs, which is well below the general target of vaccination required to interrupt transmission. In many rural areas, dogs are unregistered, uncontrolled, and allowed to roam freely, leading to more frequent encounters with other dogs, people, and waste-enriched environments (52, 53). Urban areas such as Beijing have more stringent registration requirements and higher vaccination rates. However, stray and free-roaming dogs are still difficult to reach, especially in commercial and redevelopment zones with high population density (54).

A similar situation exists in Sri Lanka, where vaccination is less accessible, depending on ownership status and roaming behavior. About “34% of owned dogs were reported to roam freely during the day, and the overall vaccination coverage was 48%, which is below the recommended level of 70% for effective protection at the population level. Vaccination rates were higher with confined-owned dogs, suggesting that mobility, uncertain ownership, and accessibility are key operational challenges (46). Sri Lanka’s rabies elimination initiatives have thus focused on dog vaccination, responsible dog ownership, public awareness, and improved surveillance. However, there is a need for better coordination between population management and environmental interventions in areas where dogs tend to gather around food waste sites (23, 55).

Common methods for humane dog population management include sterilization, animal birth control, catch-neuter-vaccinate-return (CNVR), trap-neuter-vaccinate-return (TNVR), rescue, and sheltering. India has heavily depended on animal birth control and mass dog vaccination; however, large dog populations could continue to be sustained by the availability of food from household waste, markets, slaughterhouses, and open garbage sites, limiting the long-term impact of interventions that do not address the environmental carrying capacity (26, 56). In Sikkim, the SARAH program showed how the use of humane dog management and rabies control can be linked to better collection of garbage by the municipality, with waste reduction potentially serving as a supportive measure, as it reduces access to food and limits dog aggregation and movement (45).

Animal welfare groups in Pakistan contribute by rescuing, sheltering, vaccinating, sterilizing, and TNVR or CNVR. These programs, however, are usually small in comparison to the size, distribution, and turnover of urban free-roaming dog populations. They are also limited in terms of sustainability due to a lack of funding, coverage, and institutional support (40). The mass dog vaccination and animal birth control program in Karachi is a good example of how an integrated program can be realized through collaboration between veterinarians, public-health professionals, civil society, municipal authorities, and international partners (57). However, these programs must be backed up over time and coupled with responsible ownership, community participation, and municipal waste management, instead of merely being dog removal or sterilization programs.

Another key element in dog population management is responsible dog ownership. Unrestricted dogs, even if owned, can contribute to the free-roaming population if they are allowed to scavenge, are not vaccinated or sterilized, or are abandoned. This is especially a problem in places like China, Sri Lanka, the Philippines, Kenya, and other environments where a significant percentage of dogs that appear to be owned are allowed to run free. Continuous changes between owned and free-roaming categories can be reduced through registration, confinement where appropriate, routine vaccination, sterilization, prevention of abandonment, and participation of puppies in vaccination campaigns.

Human rabies prevention infrastructure should be in place in parallel with canine interventions. Post-exposure prophylaxis is still very relevant in countries where the incidence of dog bites is high and transmission of canine rabies is ongoing. Evidence from Pakistan, Bangladesh, Iran, and Lebanon shows that there is a significant bite burden, underreporting, delayed health care seeking, incomplete follow-up, and unequal access to prophylaxis. There is a lack of awareness, diagnostic challenges, and limited access to post-exposure prophylaxis (PEP) in Pakistan, especially in rural and underresourced areas (58, 59). Nevertheless, some rural populations in Iran have a higher rate of delayed prophylaxis despite having a bite-reporting system (60).

Rabies vaccines are available in public health centers in Lebanon; however, low awareness, barriers to access, incomplete follow-up, and limited reporting impact the effectiveness of these services (21, 61). Although the availability of human anti-rabies vaccines has improved in Bangladesh, fatal cases have been reported due to late or missed post-exposure prophylaxis, highlighting the need for public awareness, prompt referral, and integration of human and animal-health services (62).

7 Surveillance, governance, and intersectoral coordination gaps

Beyond vaccination, dog population management, and post-exposure prophylaxis, the effectiveness of rabies-control infrastructure relies on reliable surveillance, effective governance, and coordination between municipal, veterinary, public-health, environmental, and community institutions. In the countries reviewed, these systems were often disjointed. Data on dog bites, rabies cases, estimates of dog population, vaccination coverage, and environmental data were often gathered by different sectors, making it difficult to pinpoint high-risk areas, allocate resources, and assess the impact of waste management and rabies-control interventions (23, 47, 57).

Although there is an ecological link between environmental sanitation, free-roaming dog populations, and human exposure, waste management and rabies prevention are often delivered by different institutions. Barriers to the sharing of data, joint planning, and coordinated action among municipal authorities, veterinary services, public health departments, environmental and wildlife agencies, animal welfare organizations, and communities may be created by fragmentation. This separation is found in Pakistan, where waste management, rabies surveillance, dog vaccination, and population management are not well integrated, and in Sri Lanka, where human, animal, and wildlife surveillance systems are not using consistent data standards and have limited exchange of bite and case information (14, 23, 57).

Thus, intersectoral coordination is required to convert surveillance findings into action. Bohol’s program in the Philippines illustrates the importance of coordination among various sectors of rabies control, such as agriculture, public health, education, environmental officials, legal systems, local governments, schools, and communities (48). In Bangladesh, the integration of dog population estimation, mass vaccination, human post-exposure prophylaxis, surveillance, public education, and public–veterinary collaboration is also underway (47, 62). A pilot study in Karachi also demonstrated that veterinarians, public-health workers, municipal authorities, civil-society organizations, and international groups can work together on vaccination and dog-population management initiatives in Pakistan (57). These examples show that multisectoral programs are possible, but they require sustainable funding, clearly defined institutional responsibilities, shared data systems, and ongoing community engagement.

The problem of fragmentation across sectors is illustrated in Sri Lanka, where the interpretation of rabies risk is limited. Surveillance is split among human health, animal health, and wildlife authorities, and data standards are inconsistent; wildlife surveillance is limited, and there is poor integration of bite and case information. Such a separation makes it challenging to fully understand the dog–wildlife–human interface, especially where free-roaming dogs congregate around food-waste disposal sites. The combination of dog-bite reports, laboratory-confirmed rabies cases, vaccination coverage, dog population records, wildlife observations, and waste-site mapping could help identify local transmission and exposure hotspots (23).

Political instability, disruption of municipal services, and poor reporting can all contribute to rabies-control vulnerability, as in the case of Lebanon. The waste-management crisis, which started in 2015, led to the buildup of garbage in residential neighborhoods and streets, and conflict and population displacement put extra stress on public health services (21). There were thousands of animal bites, and rabies vaccines were available at Ministry of Public Health centers. However, reporting was incomplete, access in rural areas was difficult, awareness was low, and follow-up was inadequate, all of which limited the effectiveness of prevention activities (61). The crossing of borders with neighboring rabies-endemic areas adds another governance challenge that needs coordination beyond municipal and national health systems.

Waste governance is also a key component of rabies prevention, as inadequate waste governance can keep feeding resources available for free-roaming dogs. In Pakistan, underfunding, lack of policies, open burning of waste, waste disposal in water channels, and other factors indicate significant limitations in municipal solid waste management (63). Similar implementation gaps are evident in the Philippines. While Republic Act 9003 has provided a formal structure for solid waste management and mandated the establishment of Material Recovery Facilities, its implementation is hindered by a lack of funding, limited land availability, maintenance issues, limited facility availability, limited public awareness, and poor cooperation among stakeholders (64). As illustrated by these examples, legislation does not guarantee that organic waste is effectively controlled when it is accessible to dogs.

Governance and enforcement in China illustrate how they can differ between rural and urban areas. Rural dogs are often unregistered, unrestrained, and under-vaccinated, while cities like Beijing have stricter registration and vaccination rates. However, stray dogs still pose a problem in commercial, densely populated, and redevelopment areas (52–54). The urban–rural dichotomy indicates that implementation of national rabies policies needs to be locally adapted, particularly if there are significant differences in dog ownership, access to veterinary services, and enforcement capacity.

Accurate estimates of dog populations are also needed for planning and monitoring vaccination programs. The situation in Bangladesh is comparatively good, with national human-to-dog ratio and dog-density estimates used to support mass dog vaccination planning (47). However, there is significant variation between urban and peri-urban dog populations, with a high proportion of free-roaming and stray dogs, suggesting that national averages may be limited in their ability to represent local conditions (49). Routine local population estimates are therefore required to determine where vaccination coverage might be overestimated or where unowned populations are not adequately covered.

Spatial surveillance can assist in the targeted use of rabies-control resources; however, its use is patchy. Geospatial mapping was used to identify dog-bite clusters and highlight high-risk dog-bite areas for vaccination, sterilization, and public health interventions in India (65). Spatial analysis of free-roaming dog-bite incidents in Iran revealed high-risk areas in Tehran Province. It demonstrated that the risk of dog bites was associated with distance from roads and parks (66). National and provincial bite registries in Iran also offer valuable data on the populations affected and delays in post-exposure prophylaxis (PEP) (60, 67). However, these surveillance systems would be more informative if bite data were routinely combined with estimates of dog density, vaccination coverage, waste-disposal sites, markets, slaughterhouses, and other environmental factors.

African cases also illustrate the importance of linking community observations to formal surveillance. In Cameroon, open garbage dumps have also been recognized as significant feeding spots for stray dogs, and open domestic feeding has been linked to human rabies transmission (22). Dog roaming, scavenging, household feeding, sanitation-associated waste, and spatial connectivity between households are important aspects of free-roaming dog ecology in Kenya, Zimbabwe, and South Africa (3, 31, 68, 69). However, there is no evidence that these ecological observations are consistently connected to formal rabies surveillance, vaccination records, or municipal sanitation data. This reduces the ability to assess whether environmental changes affect dog contact networks or rabies risk.

8 Evidence for integrated one health interventions

The surveillance and governance gaps identified across rabies-endemic settings suggest that single interventions would not likely result in sustained control. Linking mass dog vaccination, humane dog population management, responsible dog ownership, environmental sanitation, dog bite surveillance, post-exposure prophylaxis, and community participation is necessary through integrated One Health programs. However, the evidence reviewed is of widely varying quality. There have been measurable increases in vaccine coverage and rabies outcomes in some country programs, while evidence of the direct impact of waste management is still limited (45, 47, 48).

One of the most successful examples of a multisectoral coordinated intervention is the Bohol Rabies Prevention and Elimination Project in the Philippines. Program participants included agriculture, public health, education, environmental authorities, legal institutions, local government, schools, and communities. The program’s activities included dog population surveys, compulsory registration, mass dog vaccination, dog population management, enhanced bite treatment, improved surveillance and diagnostic capacity, school-based education, and expanded access to post-exposure prophylaxis. Vaccination coverage rose from 44% in 2007 to 70% in 2008, and no human or animal rabies cases were diagnosed between October 2008 and November 2010 (48). These findings show that measurable improvements can occur when canine vaccination is coupled with monitoring, control, education, and access to human health services.

The Philippines provides evidence that intervention design must consider the age and ownership structure of the dog population. Evidence from modeling suggests that puppies should be included in mass vaccination campaigns, and prospective observations suggest that a significant proportion of animals associated with human rabies cases are puppies. Many implicated dogs were owned by the patient’s household or neighbors and were not truly unowned (50, 51). These findings indicate the need for a comprehensive rabies program that includes interventions for visibly straying dogs, responsible ownership, puppy vaccination, household education, and timely post-exposure prophylaxis.

A vaccination-based One Health approach with population estimation and human rabies prevention has been implemented in Bangladesh. However, in some urban and peri-urban contexts, there is a high number of free-roaming and unowned dogs, suggesting that regular local surveys and campaigns are needed (49). The reported human death after delayed and missed prophylaxis further supports the need for public education, effective referral systems, and coordination between veterinary and human health services with any canine vaccination (62).

In India, evidence exists that environmental management can contribute to vaccination and humane control of the dog population. The SARAH program in Sikkim integrated rabies-control activities with enhancements in municipal garbage collection. Increased frequency of waste collection was believed to have decreased the amount of food available to free-roaming and feral dogs, aiding in their control and management (45). This case illustrates that environmental sanitation can be used as a supplementary measure and not as a substitute for vaccination. However, the program did not include a detailed assessment of individual waste management elements, such as source segregation, covered storage, and slaughterhouse waste control. Hence, its environmental impact should be viewed as supporting evidence and not as evidence of a direct causative reduction in rabies risk.

The overall experience in India also demonstrates that the use of animal birth control and mass vaccination, with a high prevalence of open waste, is not sufficient. Household waste, markets, butchering shops, slaughterhouses, restaurants, and garbage points can help the dog survive and aggregate, and can limit the long-term impact of sterilization and population control programs (26, 56). Geospatial mapping of dog-bite clusters is another tool for intervention that can be used to pinpoint areas that need more focus on vaccination, sterilization, public education, and environmental management (65). Combining spatial bite data with waste-site and dog-density data would enable more efficient targeting of interventions.

Pakistan offers emerging evidence that integrated rabies-control programs are operationally feasible; however, the extent and sustainability of such programs remain unclear. A multi-layered approach, such as continuous vaccination, municipal waste management, responsible dog ownership, community education, dog-bite reporting, and post-exposure prophylaxis, is likely to be more effective (40, 57).

Sri Lanka is a good example of the need to link vaccination and ownership interventions with environmental and surveillance interventions. However, owned free-roaming dogs and dogs of unknown ownership are less likely to be vaccinated, and free food waste disposal areas can attract dogs, wildlife, and other scavengers (23, 46). A more robust intervention model would involve integrating ownership actions with vaccination, waste-site mapping, targeted environmental management, combined bite surveillance, and human, animal, wildlife, and municipal coordination.

China is an example of how interventions can be tailored to address rural-urban disparities. Managed household-waste disposal and litter containment have been recommended as supporting measures for reducing free-roaming dog access to food. However, evidence of their direct impact on rabies incidence is not yet available (70). Locally adapted strategies are thus needed, such as accessible vaccination, ownership registration, roaming control, community engagement, and disposal of household and market waste.

The Lebanese experience demonstrates how wider political and municipal turmoil can impact integrated interventions. During the garbage crisis, the accumulation of waste facilitated the proliferation of stray dogs. It provided greater exposure risks to humans, whereas conflict, displacement, barriers to access in rural areas, incomplete reporting of bites, and the disruption of follow-up posed challenges to prevention (21, 61). In these environments, a successful One Health response should not only involve regular vaccination but also a proper municipal waste management system, dog management, border coordination, bite monitoring, awareness creation, and continuous provision of post-exposure prophylaxis.

Further evidence from Cameroon, Kenya, Zimbabwe, and South Africa suggests that interventions should focus on more than just visible garbage. Open dumps, household leftovers, informal feeding, butcher waste, and sanitation-related waste can maintain free-roaming dogs. In Cameroon, dog presence around garbage and open domestic feeding was associated with rabies-risk pathways, and in Kenya and Zimbabwe, unrestricted roaming and scavenging were associated with household dog management practices (3, 22, 31). Interventions in these settings should thus include routine dog vaccination, responsible dog ownership, sanitation improvements, safe food-waste disposal, community education, and locally adapted bite-prevention measures. Where other forms of food subsidies are still available, improvements in sanitation may not be sufficient.

The strongest evidence of intervention effectiveness was found for coordinated rabies-control programs in which mass dog vaccination remained the principal measure for interrupting dog-mediated transmission. Its reach and sustainability were strengthened through complementary components such as dog population estimation, registration, responsible ownership, sterilization, inclusion of puppies in vaccination campaigns, bite surveillance, public education, and access to post-exposure prophylaxis (47, 48). Waste management is also a biologically and operationally plausible complementary intervention because reducing access to organic waste may decrease dog aggregation and environmental carrying capacity. The Sikkim program provides relevant supporting evidence by combining humane dog population management and rabies control with improvements in municipal garbage collection (45). However, direct intervention studies demonstrating that waste reduction alone, or as an added component of vaccination programs, produces measurable reductions in dog density, dog-bite incidence, or confirmed rabies cases remain limited.

Thus, measurable environmental, animal, and human health outcomes must be included in future integrated programs. These could include changes in available organic waste, the dog population around waste areas, roaming and dog aggregation, vaccination coverage, uptake of sterilization, the number of bites, use of post-exposure prophylaxis, and laboratory-confirmed rabies cases. These assessments would help to inform a One Health approach to understand whether the synergies of implementing waste management and vaccination, humane population management, responsible ownership, and public health services are more effective and lasting than doing them individually. Figure 3 presents the proposed integrated One Health implementation framework that synthesizes these complementary intervention domains and their expected outcomes. Integrated One Health interventions are needed to decrease the aggregation of free-roaming dogs, the risk of dog bites, and the spread of rabies in endemic areas based on the evidence reviewed (Table 1; Figure 3).

Table 1. Evidence-informed one health intervention framework for waste-associated free-roaming dog and rabies risk.

9 Evidence gaps and future research priorities

Although the reviewed evidence supports an association between organic waste availability, free-roaming dog ecology, human–dog contact, and rabies-control challenges, the overall evidence base remains uneven. Most available studies are observational, cross-sectional, ecological, spatial, or based on community surveys and perceptions rather than longitudinal or experimental designs (3, 22, 26, 31, 65, 66). Relatively few investigations have directly evaluated the complete pathway linking organic waste availability to changes in free-roaming dog abundance, dog-bite incidence, vaccination effectiveness, and laboratory-confirmed rabies outcomes (72). Existing studies from India, Bangladesh, Pakistan, Sri Lanka, Cameroon, and the Philippines largely examine individual components of this pathway—such as dog ecology, waste management, vaccination programs, surveillance, or bite epidemiology rather than integrating these components within a unified One Health framework (22, 23, 28, 47, 48, 57). Consequently, organic waste should be regarded as a plausible and important indirect driver of rabies risk through its influence on environmental carrying capacity, dog aggregation, and opportunities for human–dog interaction, although the magnitude, causal direction, and population-level impact of this relationship remain insufficiently quantified.

Overall, the certainty of the available evidence should be interpreted with caution. The conclusions of this review are based predominantly on observational, cross-sectional, ecological, and surveillance-based studies conducted across diverse geographical and epidemiological settings. While these studies consistently identify associations between organic waste availability, free-roaming dog ecology, human–dog interactions, and challenges in rabies control, relatively few directly evaluate the complete causal pathway from waste management to changes in dog population dynamics, dog-bite incidence, or laboratory-confirmed rabies outcomes. Furthermore, variation in study objectives, methodologies, outcome measures, and local contexts limits direct comparison across studies. Therefore, the findings of this review provide consistent evidence supporting plausible One Health relationships but should not be interpreted as definitive proof of causality. Future longitudinal, intervention-based, and multidisciplinary studies are required to strengthen the certainty of the evidence.

A major limitation is the lack of standardized measurement of dog-accessible organic waste. Studies have described household refuse, open dumps, food-market waste, restaurant leftovers, slaughterhouse residues, roadside garbage, and informal feeding as potential resources for free-roaming dogs (14, 18–20, 22). However, few studies have quantified the volume, nutritional composition, accessibility, spatial distribution, or seasonal availability of these resources. In Srinagar, waste accumulation reportedly varied by season, while the Lebanese waste crisis illustrated how disruption of municipal collection could abruptly increase dog-accessible resources (21, 73). Future studies should therefore apply standardized waste audits covering households, markets, slaughterhouses, restaurants, streets, drainage channels, and open dumping sites.

The effects of waste availability on free-roaming dog population dynamics also require stronger longitudinal evidence. Research from Indian cities has linked garbage points, feeding stations, bakeries, butcher shops, restaurants, and household density with dog presence, pack size, spatial distribution, and estimated carrying capacity (26, 28). Studies from Zimbabwe and Kenya similarly show that human-derived food resources, including household leftovers and sanitation-related waste, contribute to dog diets, scavenging behavior, and body condition (3, 31). Nevertheless, these findings do not establish whether reducing accessible waste produces sustained reductions in dog survival, reproduction, aggregation, movement, or population density. Longitudinal studies conducted before and after waste-management interventions are needed to clarify these relationships.

Geospatial integration is another important research priority. Spatial assessments in India and Iran have demonstrated the value of identifying dog-bite clusters and high-risk locations for targeted vaccination, population management, public education, and environmental action (65, 66). However, bite locations are rarely analyzed together with waste sites, dog density, vaccination coverage, ownership status, or confirmed rabies cases. Future studies should integrate the locations of garbage points, food markets, slaughterhouses, informal feeding sites, free-roaming dog populations, dog-bite incidents, post-exposure prophylaxis use, and laboratory-confirmed rabies cases within geographic information systems.

Reliable dog population estimates remain insufficient in many rabies-endemic settings. Bangladesh has used national human-to-dog ratios and dog-density estimates to guide mass vaccination, but substantial variation has been observed between urban and peri-urban populations, where more than 93% of observed dogs were free-roaming and approximately 30% were estimated to be unowned (47, 49). Classification is further complicated by owned dogs that are permitted to roam, as reported in China, Sri Lanka, and Kenya (31, 46, 53). Future population surveys should clearly distinguish confined owned dogs, owned free-roaming dogs, community dogs, and unowned dogs and should account for movement between these categories.

Intervention evidence is particularly limited for waste management. The SARAH program in Sikkim suggested that improved municipal garbage collection may complement vaccination and humane dog population management by reducing potential food resources for free-roaming dogs (45). However, the independent effects of waste collection, source segregation, covered storage, market-waste control, or slaughterhouse-waste management were not evaluated separately. Managed household-waste disposal has also been recommended in China, while improved waste collection has been proposed in Pakistan, Iran, Lebanon, Cameroon, and the Philippines (14, 19, 21, 22, 70, 74). Direct evidence showing that these measures reduce dog density, dog bites, or rabies incidence remains scarce.

Controlled, quasi-experimental, or natural-experiment studies are therefore needed to evaluate environmental interventions. Comparisons between intervention and non-intervention areas could determine whether covered bins, frequent waste collection, source segregation, regulation of slaughterhouse residues, restricted access to dumpsites, and improved management of market waste reduce dog aggregation and human–dog contact. The integrated rabies-control program in Sikkim, which combined humane dog management with improvements in municipal garbage collection, provides a relevant basis for evaluating such combined environmental and animal-health interventions (45). Similarly, the disruption of municipal waste services and subsequent garbage accumulation in Lebanon illustrates how unplanned changes in waste availability may provide natural-experiment opportunities to examine changes in free-roaming dog distribution, human exposure, and bite patterns over time (21).

Research should also compare integrated interventions with single-component programs. The Bohol Rabies Prevention and Elimination Project combined vaccination, dog registration, population surveys, surveillance, diagnostic strengthening, school education, bite management, and access to post-exposure prophylaxis and achieved measurable improvements in vaccination coverage and rabies outcomes (48). Bangladesh has similarly combined mass dog vaccination with population estimation and expanded access to human rabies vaccines (47). In Pakistan, the Karachi pilot demonstrated the operational feasibility of combining mass vaccination and animal birth control through collaboration among veterinary, public-health, municipal, civil-society, and international stakeholders (57). However, few studies have compared whether adding environmental sanitation to such programs produces greater or more sustained benefits than vaccination and population management alone.

Future intervention evaluations should measure outcomes across environmental, animal-health, and human-health domains. Environmental indicators should include the quantity and accessibility of organic waste, the distribution of open dumps and feeding sites, and changes in dog aggregation around these resources, as studies from India, Cameroon, Zimbabwe, and Kenya indicate that waste availability, scavenging opportunities, and informal feeding can influence dog abundance, movement, and spatial distribution (3, 22, 26, 28, 31). Animal-health indicators should include dog density, roaming behavior, vaccination coverage, sterilization uptake, ownership and registration status, and the proportion of unowned or unrestricted dogs, consistent with population-estimation and vaccination studies from Bangladesh, Sri Lanka, China, and the Philippines (46–49, 53). Human-health outcomes should include dog-bite incidence, post-exposure prophylaxis use, delays in treatment, and laboratory-confirmed human and animal rabies cases, as emphasized in studies from Pakistan, Bangladesh, Iran, Lebanon, India, and the Philippines (58, 60–62, 65). Intervention costs, operational feasibility, and community acceptance should also be assessed because sustained implementation depends on institutional capacity, public participation, and multisectoral coordination (23, 45, 57). Long-term follow-up is particularly important because short-term reductions in visible dogs may not reflect sustained changes in population recruitment, migration, ownership transitions, or access to alternative food resources.

Surveillance limitations further restrict interpretation of existing evidence. Underreporting of dog bites and rabies, delays in seeking post-exposure prophylaxis, incomplete follow-up, limited diagnostic confirmation, and fragmented data systems have been reported in Pakistan, Bangladesh, Sri Lanka, and Lebanon (23, 58, 61, 62). Iran has comparatively detailed bite registries and spatial analyses, but these data have not been routinely integrated with waste-disposal sites, dog population estimates, or vaccination coverage (60, 66, 67). Future One Health surveillance systems should establish shared definitions and interoperable reporting across public-health institutions, veterinary services, diagnostic laboratories, municipalities, wildlife agencies, and community organizations.

More research is also required on the social and behavioral drivers that maintain dog access to waste. Intentional feeding, informal caregiving, unrestricted ownership, abandonment, household disposal practices, and reliance on dogs for guarding can influence roaming and scavenging patterns. Evidence from China, Sri Lanka, the Philippines, Kenya, and Cameroon shows that owned or semi-owned dogs may roam freely, remain inadequately vaccinated, or depend on household leftovers and open feeding (22, 31, 46, 51, 53). Mixed-methods studies combining household surveys, interviews, direct behavioral observation, dog tracking, and waste assessments could clarify the motivations underlying these practices and identify acceptable behavior-change strategies.

The contribution of different anthropogenic food resources should also be compared. In Zimbabwe, human feces represented a nutritionally important component of free-ranging dog diets, while household leftovers were commonly available to roaming dogs in Kenya and South Africa (3, 68). In Pakistan and India, butcher shops, slaughterhouses, restaurants, markets, and open dumps were repeatedly identified as potential feeding or aggregation locations (20, 26, 28). Improved municipal garbage collection alone may therefore be insufficient if dogs can shift toward household feeding, slaughter residues, sanitation-related waste, or other alternative resources.

Geographical evidence gaps should also be acknowledged. Available research is concentrated in selected urban or peri-urban areas, while rural communities, informal settlements, conflict-affected populations, border regions, and underserved locations remain inadequately studied. The Lebanese experience shows how conflict, displacement, cross-border movement, and disruption of municipal services can alter both waste exposure and rabies-control capacity (21). Similar contextual factors should be considered when designing future studies in politically unstable or resource-limited settings.

Overall, future research should move beyond descriptive associations toward longitudinal, geospatial, and intervention-based designs. Existing studies demonstrate the value of spatial mapping, repeated dog-population estimation, vaccination monitoring, and integrated intervention assessment, but these approaches have generally been applied separately rather than within a unified environmental–animal–human health framework (47–49, 65, 66). Standardized measurement of accessible organic waste should be combined with repeated dog-population surveys, assessment of roaming and spatial connectivity, vaccination and sterilization monitoring, bite surveillance, and evaluation of community practices. Studies from India, Kenya, Zimbabwe, and Cameroon indicate that food availability, scavenging, household feeding, and waste sites are relevant to dog distribution, movement, and human exposure, while intervention programs in Sikkim, Bohol, Bangladesh, and Karachi show the importance of coordinated vaccination, population management, surveillance, education, and municipal participation (3, 22, 28, 31, 45, 47, 48, 57). Economic evaluation, implementation feasibility, and community acceptance should also be incorporated because long-term success depends on sustained financing, institutional coordination, and public participation (23, 45, 57). Such integrated research is needed to determine whether reducing access to organic waste improves the effectiveness of mass dog vaccination and humane population management and whether these combined measures produce measurable reductions in dog aggregation, dog bites, and dog-mediated rabies. At present, this combined causal pathway remains insufficiently tested.

10 Conclusions

This narrative review identifies organic waste mismanagement as a neglected environmental component of dog-mediated rabies risk in endemic countries. Mismanaged household waste, food, markets, slaughterhouses, and municipalities can provide free resources that attract free-roaming dogs, favoring their aggregation, mobility, survival, and persistence in urban, peri-urban, and rural settings. These waste-associated aggregations may increase dog–dog contact, human–dog interaction, dog-bite incidents, and operational challenges for vaccination and dog population management programs. The reviewed evidence indicates that organic waste does not directly spread rabies but may indirectly impact rabies risk by sustaining free-roaming dog populations and enhancing human–animal–environment contact opportunities. Improved waste management is essential, in addition to mass dog vaccination, post-exposure prophylaxis, responsible dog ownership, humane dog population control, public education, and surveillance, to achieve the global elimination of dog-mediated rabies. However, the environmental aspect of rabies control is not sufficiently included in many One Health programs.

Advancing towards the goal of zero dog-mediated human rabies deaths by the year 2030 will necessitate collaboration between the environmental sector, municipalities, veterinary services, public health, animal welfare, academia, and communities. Effective integrated approaches should include improved organic waste collection and disposal, regulated disposal of market and slaughterhouse waste, covered waste bins, mass dog vaccination, humane dog population management, dog-bite surveillance, school-based bite prevention, and community involvement. Finally, longitudinal studies, waste audits, dog-density mapping, geospatial identification of waste and bite hotspots, and mixed-effects modeling of waste management, dog vaccination coverage against rabies, dog-bite records, and rabies outcomes should be encouraged in future research. Including organic waste as a component of the One Health rabies-control pathway could reinforce sustainable, context-appropriate action in endemic countries.

Generative AI statement

The author(s) declare that no Generative AI was used in the creation of this manuscript.

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

Publisher’s note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Supplementary material

The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fitd.2026.1859942/full#supplementary-material

Supplementary material Supplementary material at the source

Footnotes

Edited by: Emanuele Nicastri, National Institute for Infectious Diseases Lazzaro Spallanzani (IRCCS), Italy

Reviewed by: Sunny Doodu Mante, African Filariasis Morbidity Project, Ghana

Sebastian Iglesias Osores, Universidad Nacional Agraria La Molina, Peru