Collaborative approach is key to eliminating rabies

By Access and Delivery Partnership

September 30^th, 2024

Every year, rabies claims over 60,000 lives globally, with India alone accounting for nearly 36 percent of those deaths. Despite being entirely preventable, millions continue to be at risk.

“We get a lot of calls from people enquiring whether they need to take a rabies vaccine if a cat or dog has only scratched them. We tell them they have to get vaccinated even if it is just a scratch,” says Aarti, a 26-year-old Helpline Executive who works at the Rabies Control Helpline near India’s capital city New Delhi. “I have realized that awareness about rabies is still quite limited.”

Of the more than 200 known zoonotic diseases – those that transmit from animals to humans – rabies remains one of the deadliest. It is especially prevalent in areas where frequent human interaction with stray or domesticated dogs occurs.

In India, inadequate public awareness, low vaccination coverage for dogs and a limited post-exposure prophylaxis facilities have contributed to a persistent rabies crisis. Previous efforts were decentralized, with sporadic local campaigns failing to achieve long-term impact. While initiatives such as the Animal Birth Control programme showed potential, they lacked the national cohesion needed for significant progress.

In 2021, India took a decisive turn by launching the National Action Plan for Rabies Elimination (NAPRE), aiming to eliminate dog-mediated rabies by 2030. The plan leverages a One Health approach, recognizing the interconnectedness of human, animal and environmental health. The focus is on mass dog vaccinations, better access to human rabies prophylaxis, improved waste management, dog population control and extensive public awareness campaigns.

With support from the Access Delivery Partnership (ADP), the United Nations Development Programme (UNDP) is supporting the National Centre for Disease Control (NCDC) in strengthening rabies control across the country. This collaboration has facilitated the development of State Action Plans for Rabies Elimination (SAPRE), providing tailored strategies that address each state’s unique challenges.

To further enhance access to rabies-related information and treatment, the NCDC in collaboration with UNDP India launched a dedicated rabies helpline (15400). Operated by executives such as Aarti, this initiative serves as a lifeline, offering timely information on rabies prevention, symptoms and vaccine availability. The helpline is especially beneficial for rural and underserved communities where access to medical advice can be limited.

The rabies helpline offers information on rabies prevention and vaccine availability. Photo: UNDP India.

“The National and State Action Plans, along with the rabies helpline, are crucial initiatives for the elimination of dog-mediated rabies,” said Dr. Simmi Tiwari, Joint Director at NCDC & Head of Centre for One Health. “The NCDC, together with partners such as UNDP and ADP, is committed to meeting the target of eliminating this deadly disease by 2030.”

ADP is supported by the Government of Japan and works to expand equitable access to life-saving health technologies, such as medicines, vaccines and diagnostic tools, in low- and middle-income countries by strengthening their health systems, policies and capacities.

The Way Forward

The Centre for One Health, which operates under the NCDC , is also working to strengthen rabies prevention and control through the digitalization of rabies vaccinations with the support of UNDP. This digital initiative will involve real-time monitoring of rabies vaccine stocks, tracking of beneficiaries and ensuring that all doses of the rabies post-exposure prophylaxis regimen are administered in a time-bound manner.

The proposed digital platform, which is currently under development, will centralize information and enhance collaboration among healthcare providers, municipal authorities and veterinary services.

Rabies vaccination of stray dog on streets of Delhi. Photo: UNDP India.

UNDP and the Government of India have a long-standing partnership in promoting innovative and scalable digital solutions for health. This partnership has already led to the development of multiple digital health solutions that have been brought to scale, such as the Electronic Vaccine Intelligence Network and Winning Over COVID, both of which have been instrumental in digitizing information on vaccine stocks, registrations, immunizations and issuing digital vaccine certificates.

“Leveraging technology and collaborating with multiple stakeholders is key to eliminating rabies. The Government of Japan supports such initiatives towards ending neglected tropical diseases and to achieve more resilient, equitable and sustainable universal health coverage, by contributing the promotion of research, development and supply support in collaboration with the Global Health Innovative Technology Fund and the UNDP-led Access and Delivery Partnership,” said Dr. Yosuke Kita, Director, Global Health Strategy Division, International Cooperation Bureau, Ministry of Foreign Affairs, Government of Japan

The road to rabies elimination is challenging, but through consistent efforts in public education, vaccination and digital innovation, India is steadily advancing towards its goal. By embracing a One Health approach and leveraging partnerships with organizations such as UNDP, the country is not only addressing the immediate rabies crisis but also building a framework for sustained public health improvements. Through ongoing collaboration between government agencies, healthcare professionals and the public, India is poised to set a global example in combating rabies and ensuring a healthier, safer future for all.