A more centralised approach to tackling rabies is needed if the disease is to be effectively handled in India, an expert claims.
Lack of coordination between medical groups ands the veterinary community, should place managing India’s rabies burden into the hands of the central government. This is an alternative to its being left in the hands of state governments, according to Dr MK Sudarshan, founder president and mentor for the Association for Prevention and Control of Rabies in India (APCRI) in Bengaluru.
Rabies is a vaccine-preventable disease. However, its relative scarcity has seen its prevention become a lesser public health priority in comparison to concerns such as malaria, which have taken precedent.
Rabies very rarely has large-scale outbreaks. Typically infection cases are isolated to individuals or small groups. These infections occur in both rural and urban environments and are passed on most commonly by the bites of animals such as stray dogs.
Overwhelmingly, it is the poor and homeless who feel the brunt of these infections. These groups are far more likely to be in the streets – thereby exposed to areas where stray dogs are common.
India has around thirty million stray dogs. The problem is escalating as dogs are very rarely given any importance by the department of animal husbandry and veterinary services. As more stray dogs breed, they become more common in densely populated cities. This means that instances of rabies are likely to rise.
Communication is sparse between healthcare facilities and veterinary practices. This makes control of infected animals a difficult process. It is for this reason that Dr Sudarshan suggests an approach to rabies mediated by the central government, in order to bring together these two communities on a national level.
Dr Sudarshan cites the fact that there is a globally push towards adopting the “One Health” approach that combines both medical and veterinary services. This approach was recently spotlighted at a conference in India. In 2015, the World Health Organization (WHO) declared a global goal of “a dog-mediated human rabies-free world by 2030 or zero rabies cases by 2030”. India, however, is yet to make any substantial progress towards this aim.
Though rabies is relatively rare, it is the only disease in the world known to have a 100 percent mortality rate. By comparison, mortality rates for Japanese encephalitis and swine flu were twelve and six percent respectively. Of the myriad of rare diseases in India feared for their lethal potential, no other disease was found to have a 100 percent risk of death.