India aims to eliminate rabies by 2030: Study

While India has witnessed a 75% decline in rabies-related deaths in the last two decades, the availability of anti-rabies vaccines in the primary health centres (PHC) and regions such as north-east and eastern regions remains low.

The study led by Indian Council of Medical Research-National Institute of Epidemiology (ICMR-NIE) and published in The Lancet, India accounts for more than 5,700 deaths owing to rabies annually and over 9 million animal bite cases are reported annually. Of these nearly two-thirds are cases of dog bites.

While anti rabies vaccine (ARV) was available in approximately 80% of public health institutions, there were disparities between primary, secondary and tertiary care levels. The availability of both ARV and rabies immunoglobulin (RIG) was the lowest in the primary care health facilities. Similar, disparity was also evident in the availability of ARV and RIG across different geographic regions, especially in the northeast, north and eastern zones.

The survey was conducted across 60 districts in 15 states. The study assessed 534 public health facilities. Of these, 467 were public sector health facilities, including 320 primary, 121 secondary and 26 were tertiary care institutions.

India has launched a national action plan for dog-mediated rabies elimination by 2030 under the national rabies control program (NRCP) to accelerate progress towards the 2030 target. A vital component of this plan is to ensure the availability of affordable rabies biologicals — anti-rabies vaccine (ARV) and rabies immunoglobulin (RIG) for all animal bite cases at every level of health care.

ARV and RIG are provided free of cost in most of the public sector health facilities in India.

Dr Manoj Murhekar, Director of the ICMR-NIE, said, “We conducted a nationwide survey to estimate the burden of animal bites. The last data we have had on this was in 2003. 80% of health facilities had a rabies vaccine. In order to achieve the rabies elimination target by 2030, it is important to make the vaccine available in all the health facilities. It is necessary to make monoclonal antibodies vaccine available. We need to ensure dogs are vaccinated. We need to improve surveillance in animals so that we could know the number of dog deaths due to rabies.”