PUBLIC health facilities, in particular those in Sindh’s remote districts, are facing acute shortages of the lifesaving anti-rabies vaccine. Patients are forced to travel to Hyderabad from as far as Sanghar, Tharparkar and other districts for treatment. The severity of the situation can be gauged from the number — a total of 423 in October and 1,226 in November — of patients who were brought to Hyderabad hospitals for treatment. Sindh is not the only province that periodically faces rabies vaccine shortages. It is often unavailable in other parts of the country as well. For example, there were reports of severe shortages in Peshawar earlier this year. The health authorities blame the unavailability of the vaccine on import delays every few months. But other factors, including the lack of capacity to forecast need, irregular demand by hospitals and poor coordination — are also causes of the shortage.

Rabies is a major health problem in Pakistan: it is underreported and underdiagnosed, and the fight against it is underfunded. Vaccine shortages make the issue even worse, with Pakistan among the top five countries in the world with endemic human rabies. It sees between 2,000 and 5,000 deaths every year. It is one of the three South Asian countries — the other two being India and Bangladesh — with the highest regional disease burden. Researchers have found a lack of rabies case data, nonexistent target surveillance systems, and the dearth of laboratories capable of diagnosing rabies in animals and humans as major barriers to disease control. The only positive development is that Islamabad recently joined a programme being implemented by the Food and Agriculture Organisation to strengthen the capacity for rabies elimination in Asia. The government is looking for technical assistance from FAO to provide dog vaccination and distribute communication material on rabies’ risks and how to mitigate these. One hopes it will help fight and reduce the disease burden and death toll.

Published in Dawn, December 18th, 2023