Rabies remains one of the most tragic paradoxes of India’s public health landscape. Despite being completely preventable through timely medical intervention, the disease continues to claim nearly one-third of global rabies deaths in India. The reality inside rabies wards—where patients are admitted not for cure but for palliative care—exposes deep systemic failures rooted in poverty, weak health infrastructure, policy gaps, and social neglect.
Why Rabies Is Uniquely Fatal and Fearsome
Rabies is caused by a neurotropic virus that enters the body through animal bites, most commonly from dogs. Unlike many infectious diseases, the virus travels slowly along peripheral nerves to the brain, remaining clinically silent for weeks or even months. This deceptive incubation period often leads victims to underestimate the danger.
Once symptoms such as hydrophobia, hallucinations, paralysis, and extreme agitation appear, survival is virtually impossible. At this stage, treatment cannot halt viral progression, as the virus does not circulate in the bloodstream where medicines can act. Hospitals can only sedate patients and manage distress, making advanced rabies a certain death sentence.
India’s Disproportionate Disease Burden
Globally, rabies causes around 59,000 deaths annually. India alone accounts for approximately 20,000 of these fatalities, with dogs acting as the primary reservoir. The disease is endemic, not episodic, making it a chronic public health challenge.
The burden falls overwhelmingly on vulnerable populations—rural residents, daily wage workers, waste handlers, brick kiln labourers, and children. Nearly 40% of dog-bite victims are under the age of 15. With an estimated 80 million free-roaming dogs and nearly 20 million dog bites reported each year, India faces a sustained risk environment where exposure is routine and protection uneven.
Failure of Prevention Despite Clear Medical Protocols
Medical science offers a clear and effective response to rabies through post-exposure prophylaxis (PEP). This includes immediate washing of the wound with soap and water, followed by anti-rabies vaccination, rabies immunoglobulin (RIG) for severe bites, and tetanus protection.
However, prevention fails at multiple levels. Awareness remains limited, particularly in rural and peri-urban areas, where minor scratches are often ignored or treated through traditional remedies. Delays in seeking care are common, and even when victims reach healthcare facilities, vaccines and immunoglobulins are frequently unavailable.
Studies indicate that a significant proportion of dog-bite victims either receive no vaccine or fail to complete the full course. RIG, which is essential for deep or bleeding wounds, is scarce and expensive, placing it beyond the reach of poor households. These gaps convert a medical certainty of prevention into an administrative and social failure.
Economic Barriers and Health System Weaknesses
Rabies highlights the structural weaknesses of India’s healthcare financing. High out-of-pocket expenditure discourages timely treatment, especially for marginalised families. Fragmented referral systems, refusal of hospital admission, and inconsistent seriousness in managing dog bites further compound the risk.
Despite being one of the largest producers of anti-rabies vaccines globally, domestic availability remains inadequate due to production shortfalls and exports. Institutional neglect, rather than lack of scientific knowledge, emerges as a primary cause of rabies deaths.
Stray Dog Management and Policy Dilemmas
India’s primary strategy for controlling dog-mediated rabies has been the Catch–Neuter–Vaccinate–Release (CNVR) model. While conceptually humane, its effectiveness at scale remains contested due to uneven implementation, limited monitoring, and poor urban governance.
Judicial interventions directing the removal of stray dogs from
Month: Current Affairs - December 28, 2025
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