Context:
Rabies remains one of India’s most neglected yet deadly public health challenges, disproportionately affecting the poorest and most vulnerable populations. Despite being entirely preventable, India continues to account for nearly one-third of global rabies deaths, exposing deep gaps in healthcare access, affordability, and governance.
Key Highlights:
Burden of Rabies in India
-
India records around 20,000 rabies deaths annually, accounting for one-third of global fatalities.
-
The disease is endemic, with dog bites being the primary source of transmission.
-
Children under 15 years, daily wage workers, waste collectors, and rural populations are most affected.
Nature of the Disease
-
Rabies is a neurotropic viral disease.
-
The virus travels through peripheral nerves to the spinal cord and brain.
-
Leads to paralysis, hydrophobia, delirium, and cardio-respiratory failure.
-
Once symptoms appear, rabies is almost 100% fatal.
Post-Exposure Prophylaxis (PEP)
-
PEP is life-saving if administered promptly after a bite.
-
Includes:
-
Immediate wound washing
-
Anti-rabies vaccination (ARV)
-
Rabies Immunoglobulin (RIG) for severe (Category III) bites
-
-
A 2025 study found:
-
20.5% of bite victims did not receive ARV
-
Nearly 50% failed to complete the full vaccine course
-
Access, Affordability, and Systemic Gaps
-
RIG shortages are widespread.
-
Cost of RIG ranges between ₹5,000–₹20,000, making it unaffordable for the poor.
-
Many patients are:
-
Turned away from public hospitals
-
Forced to seek treatment from unqualified practitioners
-
-
India produces 50 million ARV doses annually but requires 60 million, while 15 million doses are exported, worsening domestic shortages.
Judicial and Policy Responses
-
In November 2025, the Supreme Court directed states to:
-
Relocate stray dogs from public areas
-
Ensure sterilisation and vaccination
-
Develop proper shelter infrastructure
-
-
India has developed two Rabies monoclonal antibodies (RmAbs), currently under pharmacovigilance, offering hope for affordable alternatives to RIG.
Social Justice Dimension
-
Rabies deaths reflect:
-
Healthcare inequity
-
Poverty-linked disease burden
-
Failure of preventive public health systems
-
-
The disease traps families in a cycle of medical debt, trauma, and loss of livelihood.
Relevant Prelims Points:
-
Issue: High rabies mortality in India.
-
Key Facts:
-
~20,000 deaths annually
-
One-third of global rabies deaths
-
-
Transmission: Dog bites (saliva).
-
Key Terms:
-
Rabies
-
Post-Exposure Prophylaxis (PEP)
-
Rabies Immunoglobulin (RIG)
-
-
Recent Developments:
-
Supreme Court directive on stray dog management
-
Indigenous Rabies monoclonal antibodies
-
Relevant Mains Points:
-
Science & Technology:
-
Virology of rabies and prevention mechanisms.
-
Role of vaccines, immunoglobulins, and monoclonal antibodies.
-
-
Governance and Public Health:
-
Weak last-mile healthcare delivery.
-
Poor hospital responsiveness to dog-bite cases.
-
-
Social Justice:
-
Disproportionate impact on the poor and children.
-
Rabies as a marker of health inequality.
-
-
Economic Impact:
-
High out-of-pocket expenditure.
-
Loss of productivity and income.
-
-
Way Forward:
-
Ensure free and universal access to PEP.
-
Scale up domestic ARV and RIG production.
-
Prioritise dog population management through sterilisation and vaccination.
-
Compensate treatment costs for vulnerable groups.
-
Strengthen primary healthcare accountability.
-
Integrate rabies control into One Health approach.
-
UPSC Relevance (GS-wise):
-
GS Paper II – Social Justice: Health equity, vulnerable populations.
-
GS Paper II – Governance: Public health delivery, judicial intervention.
-
GS Paper III – Science & Technology: Vaccines, monoclonal antibodies.
-
GS Paper III – Economy: Healthcare costs, poverty impact.
-
Prelims: Rabies, PEP, RIG, Supreme Court directives.