By Gayathri G
In 2022, India saw a steep increase in dog bite cases and rabies deaths. According to available data, India reported total 72,77,523 cases of animal bites in 2019, which dropped to 46.33 lakh cases in 2020 and 17.01 in 2021. However, the country has recorded 14.5 lakh cases in the first seven months of 2022 alone.
Another shocking aspect was human deaths. The death of a 12-year-old girl in Kerala in September, even after receiving rabies vaccines, stirred a discussion on rabies and the efficacy of the existing vaccines in curbing its spread.
This explainer takes a deep dive into India’s efforts to fight rabies, programmes and policies that are in place and the legal position on this important public issue.
Rabies in India
As per WHO, Rabies is a viral tropical zoonotic disease transmitted through the bite of rabid animals that causes progressive and fatal inflammation of the brain and spinal cord. It is however preventable by timely vaccination.
The WHO attributes India to approximately 36% of the world’s human rabies deaths transmitted by dogs. The disease is endemic throughout the country and is very common with an annual estimate of 1.7 crore dog bites. Tamil Nadu has been reported to have the state with the most number of dog bite cases with approximately 251510 cases, followed by Maharashtra which reported 231531 cases. The presence of unvaccinated free-roaming dogs (FRD) or street dogs is considered to be a major reason for the high incidence of Rabies in India.
National policies on rabies control
One of the significant steps taken by India in its fight against rabies was the National Rabies Control Programme (NRCP). It was approved during the 12th Five-Year Plan in 2013.
The National Guidelines for Rabies Prophylaxis, 2019 is another important step taken under the NRCP. It provides information on post and pre-exposure prophylaxis and rabies vaccines.
Rabies Postexposure Prophylaxis (PEP) consists of human rabies immune globulin (HRIG) and rabies vaccine. It is first administered on the day of rabies exposure, and then on the third, seventh and fourteenth days. As per the guidelines, it should be given in cases of bites by warm-blooded animals, rodent bites, exposure to bats etc.
Some of the main objectives of NRCP were training the health care professionals on animal bite management and PEP, strengthening Human Rabies Surveillance Systems and Regional Laboratories under NRCP for Rabies Diagnosis. It also aims to create awareness in the community through advocacy and communication and Social mobilization.
This plan also declared rabies as a notifiable disease.
Another important plan introduced by the government is the National Action Plan for Dog Mediated Rabies Elimination (NAPRE) by 2030, launched by the Ministry of Health and Family Welfare in 2021, which provides a broad framework for combating rabies. It incorporates recommendations of various international agencies like WHO, World Organisation for Animal Health, and Global Alliance for Rabies Control.
The three key principles of the plan are:
- Prevention by introducing cost effective techniques
- Promotion through awareness programmes
- Partnership by coordinating with local communities and societies
NAPRE had described roadmaps in a phase-wise manner for the state-level stakeholders, under which the first phase urges developing a legal framework to declare rabies as a notifiable disease.
Recently, Karnataka and Maharashtra have declared Rabies as a notifiable disease within their respective states.
The Karnataka Epidemic Diseases Act, 2020 now requires all government and private facilities to report any suspected or confirmed human rabies cases to the State Health Department. The state notification in Maharashtra said that “Prevention, control and elimination of rabies from a geographical area can only be achieved through strong surveillance and disease reporting system”.
In addition to these, there are several other legislations and guidelines that play a significant role in addressing the issue of rabies in the country.
Proper mechanisms for sterilization or vaccination of dogs have been mentioned under the Animal Birth Control (Dogs) Rules, 2001. Various Municipality Acts like the Delhi Municipal Corporation Act, 1957 and the Kerala Municipality Act, 1994 details the procedure to be undertaken in case of rabid dogs, including isolation of rabid dogs.
The Supreme Court had lately issued several notices and at various instances shared its opinion on increasing rabies cases and animal rights concerns over stray dogs.
Recently, the apex court issued notice on a plea seeking to examine the efficacy of the Intra Dermal Rabies Vaccines (IDRV). The Kerala Pravasi Association filed the petition and prayed for the setting up of an expert committee and ensuring proper implementation of the National Guidelines for Rabies Prophylaxis, 2019. The major issues raised in the case were regarding the current treatment protocol, procuring vaccines before receiving approval from the Central Drugs Laboratory, quality of anti-rabies vaccines administered to dogs and also sought for the issuance of a directive to the Union of India for publicizing and implementing National Guidelines for Rabies Prophylaxis, 2019.
Prior to this case, following the death of a girl in Kerala due to rabies even after being administered three of four vaccines, the State Health Minister had written to the Hon’ble Health Minister Mansukh Mandaviya requesting him to check the efficacy of the vaccines in Kerala. However, an expert panel constituted by the central government clarified that the deaths in Kerala due to rabies were not because of ineffective vaccines but were caused due to improper and delayed treatment.
India has up to 30 million stray dogs who often come into conflict with people. The risk they pose to public health also arises from the fact they are carriers of rabies. The discourse around feeding strays and how it could negatively affect public health was brought to light. Many argued that providing goodies to canines can make them dependent and insolent while others highlighted how even these creatures have a right to food and life.
The Bombay High Court had prohibited the public feeding of street dogs and held that persons who feed them must adopt them. It also directed that a fine of ₹200 be levied in such a case. However, the Supreme Court stayed this order. The petitioners in this case referred to the decision in Animal Welfare Board of India v. A. Nagaraja which recognized the animals’ right to life and dignity and the right to get protection from human beings.
Section 3 of the Prevention of Cruelty to Animals Act, 1960 also guarantees animals, the right to food and shelter.
The Supreme Court had, in October, declined Kerala’s plea to kill rabid stray dogs further upholding the animal’s rights. It also vacated an interim stay on Delhi High Court’s verdict which guaranteed the stray dog’s right to food.
Notably, the Animal Welfare Board of India (AWBI) issued advisories upon receiving information regarding atrocities committed against dogs and feeders. It urged the Municipal Corporations to implement the Anti Birth Control (ABC) and Anti Rabies Program jointly. It also prohibited Resident Welfare Associations from denying the feeding of dogs in areas where these dogs reside.
The way forward
One of the main reasons for death by rabies is due to lack of proper and timely treatment after being bitten by an infected animal. Lack of surveillance of stray dogs also poses a severe challenge in curbing the disease. Vaccination of stray dogs needs to be considered seriously and implemented properly. Another important factor that requires consideration will be maintaining the balance between the elimination of the disease and the rights of animals. NAPRE and its objectives, if implemented properly, might prove to be an excellent tool in this fight.
Furthermore, one of the arguments raised in the Supreme Court, while requesting for an expert committee to judge the efficacy of vaccines, was the lack of care during the manufacturing and testing of the same. Such concerns should also be given due attention and dealt with properly. Vaccination is the only way out in case of rabies and thus it should be taken seriously. Manufacturers should be made to adhere to the rules and regulations strictly.
Gayathri is a student of law at Christ University, Delhi-NCR campus and she is currently an intern with TA.
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