Thirty years ago I lost an uncle to rabies. His pet dog was not vaccinated against rabies and he licked a scratch on my uncle’s knee leading to a very painful death. Just five years back, in a rural area, a farmer was attacked by a rabid dog while working in his fields. He did not seek appropriate treatment due to lack of awareness and died soon after. This was not registered as a death due to rabies because he did not go to a hospital. Rabies, once contracted, cannot be cured and results in death. In India, there are 20,000 people dying of rabies every year. This is 36% of the total human rabies deaths worldwide! Has nothing changed in India in these 30 years?
In spite of this, no national programme on rabies has been announced. Rabies control is slightly complex in India as it involves both humans and animals – mostly stray dogs. In India, dogs are most often the carrier while the disease manifests in humans as well as other mammals. Post-bite anti -rabies treatment, including vaccinations for humans, are provided free of charge in public hospitals.
For any rabies control programme, multi-sector collaboration would be needed. This would include Ministry of Health, Ministry of Environment, Ministry of Agriculture, municipal corporations in the cities and, of course, civil society organisations for last mile delivery of services. In India, the large stray dog population often carries rabies but nothing is done to address this health and safety concern! Until this issue is addressed, rabies cannot be controlled effectively!
The best option is to vaccinate the dogs. This is easier said than done! Trained dog catchers are difficult to find as it is not a profession of choice for people. There are also few vaccinators and the number of dogs that need to be caught to be vaccinated is huge. Moreover, even if one manages to vaccinate dogs in an area, the rate at which they breed (every six months a litter is produced) will create a strain on vaccinators. Therefore, when dogs are vaccinated against rabies, they should also be neutered or spayed as the case may be. This means that there is a need for trained vets and the resources to fund this programme. While funds for the human side of rabies control are forthcoming, no one is ready to foot the bill for curtailing the dog population or vaccinating them!
A comprehensive policy on rabies control in India should cover:
a) Provision for post-bite treatment to humans
b) Vaccination of stray dogs
c) Control of dog population through spaying and neutering
d) Mass rabies awareness programme and
e) Provision for resources to do the above.
This blog post is written in support of World Rabies Day on 28th September 2015. This year’s theme is Ending Rabies Together. The Global Alliance for Rabies Control are holding worldwide events to raise awareness and to promote prevention activities in at-risk communities. To find out more about the day, follow #EndRabies on Twitter and join the conversation.