RABIES, resulting from the bite of a rabid animal, usually a dog, is prevalent in low-income populations as these are vulnerable to stray dog bites. Rabies is 100 per cent fatal, yet 100pc preventable if treated in the right manner with quality anti rabies vaccine (ARV).

India and China are the two countries that are mainly producing and exporting this vaccine to developing countries. Due to compliance issues, only one manufacturer is now able to supply ARV to Pakistan from China. Unfortunately, this is leading to a drying up of ARV supplies throughout Pakistan, and this situation will very soon lead to an uncontrollable situation of rabies deaths.

The drug regulation authority allows registration of only World Health Organisation pre-qualified vaccine in Pakistan. On Feb 7, Cadilla Healthcare Ltd announced its WHO pre-qualified ARV VaxiRab. Another manufacturer Serum Institute of India, also announced on Dec 20, 2018, its WHO pre-qualified ARV Vero cell®.

The production capacities of vaccines are limited, which means that demand for such products will far exceed the supply. Products will only go to countries that meet a base minimum retail price (MRP).

There is a dire urgency to secure allocation for WHO prequalified ARVs, hence DRAP should urgently register these products without further delay.

With the WHO pre-qualifications in place, no further documents should be awaited from the manufacturer, and a workable MRP should be granted.

I urge the authorities concerned that registration and import of the above two WHO pre-qualified, life-saving ARVs be approved as soon as possible, so that we may save the unfortunate dog bite victims from the dreaded and fatal disease rabies.

Dr Naseem Salahuddin
Head, Dept of Infectious Diseases
The Indus Hospital Karachi
Karachi

Published in Dawn, April 11th, 2019