Rabies, an acute viral disease of the central nervous system affecting humans and other mammals, may be prevented by immunization. While it is present in many countries, the problem in India is acute. MK Sudarshan currently president and mentor, Association for Prevention and Control of Rabies in India (APCRI), Bengaluru, spoke to Taru Bahl on the solutions:
Rabies is the only disease that has a 100% death rate, compared to 12% for Japanese encephalitis and 6% for swine flu in India. Why is it not a priority disease with the government?
The World Health Organization (WHO) has rightly placed human rabies under the list of "neglected tropical diseases". The pattern in countries like India has usually seen deaths that do not occur as outbreaks. These are scattered all through the year and are commonplace in both urban and rural areas, affecting mostly the poor and the homeless. As a result, neither receive proper medical care nor any media attention. Rather, it takes sustained and prolonged efforts to provide post-bite rabies prophylaxis and to educate the masses on how and where to save these life saving services. What makes the access to services even more challenging is the lack of coordination between the medical and veterinary sector, including the disease in the dogs, which is that source.
Globally there is a push now towards adopting the "One Health" approach that combines both medical and veterinary services. In the year 201
Can we get rid of its stray dog menace?
We have about 30 million stray dogs in India. Given the fact that they are not animals of economic importance, they do not receive much attention from the department of animal husbandry and veterinary services. Besides, dogs act as companion animals and support many activities like surveillance, rescue, security and relief work. For the poor they are a source of social support for vigilance. Under these circumstances, most dogs have some form of ownership by humans and cannot be strays in the strict sense of the word
In urban areas there is a program of animal birth control (ABC) conducted by the municipalities and corporations to check their population. However, this approach needs to cover about 70% of the stray dog population in any given area in approximately a one-year timeframe. Presently, the municipalities and corporations neither have the funds nor the infrastructure and facilities, or more importantly trained and qualified veterans to perform the large number of surgeries that are needed. This has led to a gross wastage of public funds, which has mostly been spent towards a haphazard and weak implementation of the ABC program.
Why is the government dragging its feet over controlling an ever-increasing dog population? 19659004] It is not a disease of public health priority and result, other competing major diseases are taken away from the limited funds that are available. Presently, state governments with meager resources are failing to provide uninterrupted life-saving rabies prophylaxis to bite victims in government hospitals. So, it is important that the disease be shifted from the radar of the state governments to the central government.
Is it true that dogs are turning into predators? What is contributing to this change in canine behavior?
In the cities, packs of hungry stray dogs lie waiting near eateries for food. When they find food in the hands of small children, by instinct they pounce on them and sometimes viciously bite them, and as a result of succumb to injuries. In the wild, sometimes pack of dogs hunting vulnerable small animals like pigs, hares. This has been prevalent since time immemorial and it is only a more sophisticated and improved reporting and tracking system that has put the spotlight on these dimensions of dog behavior.
Clearly there are gaps in India's national policy on stray dogs, rabies and its control.
The organizational structure of NRCP must be revamped to combine both medical and veterinary systems and be geared to deliver One Health services to the rabies menace, both in humans and dogs. The One Health Approach to rabies control and elimination must entail necessary integration, coordination and collaborative partnerships to eliminate canine rabies as a global human and animal health problem.
Any global examples that India can provide from and adapt its demographics and sociocultural setting?
Thailand, the Philippines and Sri Lanka are small but have made concerted efforts to successfully contain rabies, both in humans and animals. We can learn from their experience. Meanwhile, in the context of India, we have to improve our public health surveillance, animal census and implementation of dog licensing rules. Other targeted interventions would include waste management, effective anti-rabies vaccination, awareness campaigns, and widespread availability of anti-rabies vaccine at all public health facilities. A more coordinated effort has been seen involving state departments responsible for public health, municipal administration, town administrations, village panchayats and veterinary public health. The problem is complex and unwieldy at the moment, but there is no reason why it can be brought under control with some clear directives from the municipal corporations.
DISCLAIMER: Views expressed above are the author's own.