EVERY year, rabies, the deadliest zoonotic disease, kills more than 59,000 people worldwide. In Pakistan, it is one of myriad public health challenges poised to become an epidemic. Between January and April, Sindh recorded a staggering 85,891 cases of dog bites. Last year, it logged over 285,000 cases with 22 lives lost to the virus, as per data from major hospitals. While the chief minister has launched an anti-rabies campaign across Sindh, promised the availability of anti-rabies vaccines along with immunoglobulin at all health units, and stressed humane measures to control the feral dog population, such rhetoric is not new. The question is: why do reports of fatalities and culling initiatives surface so frequently when 278 WHO-standard rabies prevention units and 112 referral centres are active in the province?

Curbing the spread of rabies requires vaccinating 70pc of stray dogs. Unfortunately, given the apathy of the authorities, this goal is unlikely to be achieved. Besides, the dismal state of public healthcare infrastructure — from inadequate cold chain maintenance to poor outreach — does little to protect people, especially rural populations that remain the most vulnerable to dog bites. Lack of both qualified staff and post-exposure prophylaxis compels the underprivileged to seek alternative, often lethal, ‘treatment’. According to the health minister, anti-rabies vaccines for over 63,000 patients, along with eRIG treatment for 8,700 victims, have been provided. But any praise must be tempered with scepticism — clearly, the Trap-Neuter-Vaccinate programme is not keeping pace with the surging canine population. Anti-rabies measures cannot be slow, temporary or reactive. Without political will, preventing deaths from rabies will be difficult. The cause espoused by the late infectious disease expert Dr Naseem Salahuddin, a pioneer of rabies prevention in the country, must not be allowed to die. Her vision and achievements should both inspire and inform our prospective public health planning.

Published in Dawn, May 30th, 2026