Rabies a health priority in 12th Plan for India

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 (2012-2017). Currently India does not have a comprehensive national rabies control programme. The existing prevention activities are being carried out by various organizations and municipal bodies, and inter-sectoral coordination is lacking.

 

Strategies to prevent deaths due to rabies were developed during the 11th Plan which targeted reduction of rabies deaths in humans by at least 50 per cent by the end of the Plan period in Ahmedabad, Bangalore, Pune, Madurai and Delhi. 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.

The number of animal bites in India 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 put the number of deaths at 20,000. About 90 per cent of the mortality and morbidity due to rabies 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.The challenge is greater as the majority of dogs are stray dogs, as is the case with Srinagar where the dog:human ratio is 1:14. Another challenge is the government of India has still not made rabies a notifiable disease so many deaths go unreported.

The rabies control aspects of the 12 the plan need further elaboration and a detailed plan of action, if we want to make rabies history. Otherwise it would remain another promise that would never be fulfilled in near future.

Submitted by Dr. Omesh Kumar Bharti, CorporationHealth Officer for Shimla-1, Himachal Pradesh, India. The article is partly based on this news report from the Hindu. The report of the steering committee on health for the 12th Five-year plan can be accessed here.