I will add to the voices with no stated expertise.

When I visited Rome and asked about it, I was told at the Basilica di San Clemente al Laterano that the primary cause was frequent flooding on the Tiber, with some historical floods dumping as much as a meter of sediment in places.

https://en.wikipedia.org/wiki/San_Clemente_al_Laterano

Well, now I'm curious how taking it in the uncontained liquid form, Zzzquil, would stack up. And does the increased bioavailability in the gelcaps also contribute to faster elimination? Do you ever get woken up by your tinnitus?

Rabies, like many diseases, is dependent on local ecosystem conditions. When we have wildlife outbreaks in the U.S., they seed likely feeding areas of foxes and raccoons with a baited oral vaccine.

India has an extraordinarily complex and destructive combination of lifestyle, livelihood, religion, and economy. A big likely contributor to rabies surging there in recent decades is a specific medication given to cattle.

https://en.wikipedia.org/wiki/Indian_vulture_crisis

Distance to adequate facilities is a major hurdle in many or all of the most vulnerable countries.