New Delhi: Nearly 80% of public health facilities across India have anti-rabies vaccines available, according to a new nationwide study led by the Indian Council of Medical Research (ICMR). The study, which aims to support India’s goal of eliminating rabies by 2030, highlights both progress and challenges in ensuring access to life-saving treatment after exposure to the virus.
Published in The Lancet Regional Health - Southeast Asia, the study surveyed health facilities across 60 districts in 15 Indian states. It aimed to assess the availability of two critical rabies prevention tools: the anti-rabies vaccine and rabies immunoglobulin, both essential components of post-exposure prophylaxis (PEP).
“We found that nearly four-fifths of the public health facilities had anti-rabies vaccine,” said Dr. Manoj Murhekar, Director of ICMR-National Institute of Epidemiology (ICMR-NIE) and corresponding author of the study.
Despite a reported 75% reduction in rabies-related deaths, India still reports about 5,700 rabies fatalities each year, making it one of the highest in the world. Additionally, approximately 9 million cases of animal bites are reported annually, further emphasizing the urgent need for accessible rabies prevention.
The survey covered 534 health facilities, 467 of which were in the public sector. Anti-rabies vaccines were available in 372 of those public health centers. However, availability varied significantly by region and type of facility—from just 60% in some areas to over 93% in others.
Urban primary health centers (UPHCs) had the lowest availability of anti-rabies vaccines. In contrast, medical college hospitals had better supply levels, particularly in the southern states, where vaccine availability was highest. The northeast region showed the lowest levels of access.
The study also found that rabies immunoglobulin—a critical but costlier and less commonly stocked treatment—was available in only 95 public health facilities. Its availability ranged from as low as 1.8% in UPHCs to 69.2% in medical college hospitals.
Two-thirds of the public facilities that provided anti-rabies vaccines were following the recommended intradermal regimen, which is more cost-effective. However, others continued to use the older and more resource-intensive intramuscular method.
Dr. Murhekar warned that lack of availability on the day a bite victim visits a facility could mean missed treatment, which is potentially fatal. “The non-availability of anti-rabies vaccine can lead to victims going home without getting the jab, undermining national efforts to eliminate rabies,” he said.
The findings underscore the need for urgent improvements in the distribution and stocking of both anti-rabies vaccines and rabies immunoglobulin across all public health facilities, especially at the primary care level. Strengthening the supply chain and ensuring consistent access are key to meeting the 2030 goal of zero human deaths from dog-mediated rabies.