12th Plan priority for rabies control

Acknowledging that rabies is a major public health challenge in India, the government proposes to make it a priority disease for control under the 12th Five Year Plan.

A viral zoonotic disease primarily infecting domestic and wild animals, rabies spreads to people through close contact with infected saliva via bites and scratches. There is no treatment available globally after the disease develops. An estimated 20,000 deaths occur annually in India due to rabies.

While dogs are the main host and transmitters, others responsible for the disease are cat, mongoose, monkeys and such other warm-blooded animals.

But the disease is preventable.

Strategies to prevent death due to rabies were developed through a pilot project during the 11th Plan and these strategies are proposed to be implemented countrywide in the 12th Plan, officials in the Ministry of Health and Family Welfare told The-Hindu. The 11th Plan targeted reduction of rabies deaths in humans by at least 50 per cent by the end of the Plan period in the pilot project that covered Ahmedabad, Bangalore, Pune, Madurai and Delhi.

As of now, India does not have a comprehensive national rabies control programme. Various organisations are involved in control activities without any inter-sectoral coordination. The existing prevention activities are being carried out by municipal bodies, but no tangible results have been achieved.

Experience gained from the implementation of the pilot project indicates that the strategy is feasible, reproducible and implementable. It is now proposed to roll out a comprehensive control strategy for both human and animal components in the 12th Plan. All 35 States/UTs will be covered for the human component and the animal component will be piloted in selected 30 cities.

The programme will include training health professionals to deal with animal bites, awareness creation and minimising animal bites. On the veterinary side, the focus is on sterilisation and vaccination of dogs, with a larger involvement of civil society and municipal bodies.

Advocating the need for greater awareness of the disease, the World Health Organisation (WHO) says children and poor people are particularly vulnerable.

The disease claims 55,000 human lives across the world every year, mostly in Africa and Asia. The number of animal bites in India, however, is not reliably known, though some studies have estimated it to be as high as 17.4 million a year. The last survey conducted by the Association for Prevention and Control of Rabies in India in 2003 was supported by the WHO and it put the number of deaths at 20,000. About 90 per cent of the mortality and morbidity here is associated with dog bites.

Modern, safe and effective anti-rabies cell culture vaccines are being used for post-exposure treatment in India after the government banned the production and use of nervous tissue vaccine in December 2004. Intradermal rabies vaccination has been promoted at the State level in designated rabies clinics.

The WHO says prevention of human rabies is possible through mass dog vaccination, promotion of responsible dog ownership and dog population control programmes with a partnership approach. Many countries in South America and Asia have successfully used this strategy to eliminate transmission of rabies.

However, this is a challenge for India as it has a large population of dogs (around 25 million) and very low vaccination coverage.