DEATHS caused by rabies are rising in Pakistan, warn healthcare professionals, due to a chronic shortage of medicines used for its treatment. Rabies is a virus that is transmitted to humans via bites primarily by infected dogs — if not given timely treatment, death is inevitable. Yet there is no national stock of the post-exposure vaccine, with just a few hospitals procuring the imported vaccine from local vendors, whose stocks have dwindled in recent months. One reason why this issue remains ignored by public officials is the fact that it predominantly affects the poor — dog colonies thrive around garbage sites in densely populated areas, and a rabid dog is more likely to come into contact with a pedestrian than someone in a car. And so it is that so many who are bitten by rabid dogs are forced to die in agony — deaths that are easily preventable.
The issue of rabies, however, is not simply limited to ensuring timely access to these life-saving drugs. Effective rabies control requires a coherent policy that addresses several concomitant public health issues — inadequate sanitation and solid waste management, and burgeoning stray dog populations. Whereas the current ad hoc practice of culling dogs by poisoning or shooting is not only cruel but also ineffective, other countries have found success in adopting a strategy of trapping, vaccinating and sterilising stray dogs, before returning them to their colonies. This effectively reduces dog populations over time to manageable levels, while preventing the transmission of the rabies virus. Indeed, studies have found that vaccinating even a small portion of feral canines significantly reduces the percentage of human deaths from rabies. One pilot project recently implemented in a locality in Karachi, for example, showed promising results; within a year, in an area where dog-bite incidents were quite common, there were no incidents of rabies, fewer newborn puppies, and a community no longer living in fear of another outbreak. It is time the authorities, from the municipal to the federal level, took note.
Published in Dawn, May 27th, 2019
