Rabies persists in its destructive course
The World Health Organization (WHO) has a clear framework for rabies prevention, which includes post-exposure prophylaxis (PEP). When appropriately applied, PEP has a success rate of more than 99%. However, communities in India remain unaware of the importance of immediate wound care and timely vaccination.
Rabies is a One Health issue, existing at the intersection of human, animal, and environmental health. In 2024, over 2.1 million dog bite cases were reported across various Indian States, with over 96% of rabies deaths in India being due to dog bites. This highlights the urgent need for action.
India's National Rabies Control Programme (NRCP) aims to eliminate human rabies deaths in India by 2030. The strategy includes training healthcare professionals, promoting cost-efficient intradermal vaccination methods, improving diagnostic infrastructure, and raising community awareness.
However, surveillance of rabies is inconsistent, and rabies is not a notifiable disease in all Indian States. Many rural and remote public health systems in India do not stock essential rabies treatments. Access to critical elements like rabies immunoglobulin (RIG) or monoclonal antibodies is severely limited.
Post-exposure prophylaxis involves wound washing, administration of RIG or monoclonal antibodies, and a five-dose course of anti-rabies vaccination. Unfortunately, many bite victims are unable to complete the full PEP regimen, with around 80% receiving only one vaccine dose instead of the recommended 5-dose schedule.
The rise in bite incidents is linked to a breakdown in preventive measures such as animal birth control programs, public pet vaccination efforts, and proper waste management. There are an estimated 30 million stray dogs in India, most of which remain unvaccinated.
In 2025, India's NRCP involved collaboration among the Ministry of Health, Ministry of Fisheries, Animal Husbandry and Dairying, local civic bodies, health facilities, veterinary sectors, and urban local bodies such as those in Delhi, which also partnered with the United Nations Development Programme (UNDP) for dog microchipping and vaccination efforts. This One Health approach and multi-sectoral cooperation aim to eliminate human rabies deaths by 2030.
Children under the age of 15 and rural populations are disproportionately affected by animal bites. Health workers in India often lack training in managing bite injuries. It's crucial to address these gaps to ensure effective rabies prevention and control.
In conclusion, while progress has been made in India's fight against rabies, significant challenges remain. A comprehensive and collaborative approach that combines veterinary health services, human health systems, and environmental management is essential for meaningful progress in addressing the rabies crisis.
