Ivory Tower: Despite vaccines, rabies still kills thousands in country
Despite decades of medical advancement and the availability of effective vaccines, rabies continues to be a major public health threat in India, claiming an estimated 20,000 lives annually.
According to the World Health Organization (WHO), India accounts for 36 per cent of global rabies deaths, making it the most affected country in the world. The disease, which is 100 per cent preventable, remains endemic due to gaps in surveillance, stray dog management and timely access to treatment.
Globally, rabies causes around 59,000 deaths each year, with over 90 per cent occurring in Asia and Africa. In India, the burden is exacerbated by the high population of stray dogs, estimated at 6.82 million nationwide, with Punjab alone accounting for 0.29 million. A national survey revealed that India records approximately 9.1 million animal bite incidents annually, translating to 6.6 bites per 1,000 people. These bites, primarily from unvaccinated stray dogs, are the leading cause of human rabies infections in the country.
Rabies is caused by a virus from the Rhabdoviridae family, transmitted through the saliva of infected animals—most commonly via bites or scratches. While wild animals like bats and foxes are reservoirs in other parts of the world, in India, domestic and stray dogs are the primary vectors. The virus has an incubation period ranging from one to three months, but can be shorter if the bite is near the brain. Early symptoms mimic the flu—fever, headache, and fatigue—but rapidly progress to neurological complications such as confusion, hallucinations, paralysis and hydrophobia. Once symptoms appear, the disease is almost always fatal.
To address this crisis, the government has launched several initiatives. The National Rabies Control Programme (NRCP) focuses on mass dog vaccination, post-exposure prophylaxis (PEP) and public education. Complementing this is the Animal Birth Control (ABC) programme, which aims to sterilise and vaccinate stray dogs to curb their population and reduce transmission.
However, several challenges still persist. Many government hospitals offer free anti-rabies vaccines and Rabies Immunoglobulin (RIG), but timely access remains a hurdle, especially in rural and underserved regions. Experts stress the importance of immediate wound washing, followed by PEP, which includes a series of vaccine doses and, in severe cases, RIG administration.
Recent studies from Punjab and other states suggest that rabies incidence in animals, particularly stray dogs and cattle, may be underreported, highlighting the need for enhanced surveillance and data-driven interventions. Children under 15 are especially vulnerable, accounting for 30–60 per cent of rabies deaths, often due to unreported bites and delayed treatment.
Dr JPS Gill, Vice-Chancellor of Guru Angad Dev Veterinary and Animal Sciences University, advocates for a One Health approach, integrating human, animal and environmental health sectors to tackle rabies holistically. This includes strengthening healthcare infrastructure, scaling up dog vaccination and raising community awareness.
“Rabies is not just a veterinary issue, it is a human tragedy that continues to claim thousands of lives every year, despite the availability of effective vaccines and treatments. The solution lies in a One Health approach that integrates human, animal and environmental health sectors. Strengthening disease surveillance, improving healthcare access, scaling up dog vaccination and increasing community awareness are all critical to preventing avoidable deaths. With sustained efforts and community participation, India has the potential not only to control but to eliminate rabies in the near future,” added Dr Jasbir Singh Bedi, Director, Centre for One Health, GADVASU.
India has committed to the global goal of eliminating dog-mediated human rabies deaths by 2030, but experts warn that without sustained efforts and intersectoral collaboration, the target may remain elusive. As Dr Gill put it, “Every life lost to rabies is one too many—and with the right action, these lives can be saved.”
Ludhiana