Sep 01, 2026 Ending Human Rabies Deaths: A Global Success Story in the Making

Introduction

Rabies is a frightening viral disease that, once contracted by a human patient, is always fatal. The first phase of the infection, incubation, can last from weeks to months, during which the virus replicates without causing symptoms. The first symptoms include fever and malaise, and typically last two to ten days. The third stage includes acute neurological symptoms, including confusion, paralysis and hydrophobia (fear of water). In the final stage, the patient lapses into a coma and eventually dies of respiratory failure. Ninety-five percent of all rabies infections follow a bite from a rabid dog, but wild mammals such as foxes, skunks and raccoons can also transmit the disease.

PAHO Project to End Human Rabies in South and Central America

The World Health Organization (WHO) estimates that every year, almost 60,000 people contract and die of rabies, with approximately one-third of those cases occurring in India. Many other countries in Asia and Africa also report cases of canine and human rabies. Europe, North America, Australasia, and many Pacific island nations, including Taiwan and Japan, are canine rabies-free.

The Pan American Health Organization (PAHO) launched a project to eliminate rabies in South and Central America in 1983 and has succeeded in that goal. PAHO reported in 2018 that only nineteen people died of rabies in the region. Ninety percent of canine rabies and all the human cases occurred in Bolivia, Guatemala, Haiti and the Dominican Republic. The anti-rabies project in Mexico is a particularly good example of the benefits of a One Health approach to rabies elimination. In the 1980s, Mexico reported six hundred cases of human rabies. However, following the administration of around 18 million annual rabies vaccinations to people’s pets and roaming dogs, the WHO declared Mexico human rabies-free in 2019. Mexico is now aiming to be declared free of canine rabies. However, the rabies virus is still present in wild animals in North America. It is, therefore, important to keep a pet’s rabies vaccination status up to date.

Rabies Trends and Successes in India

The success of PAHO’s anti-rabies initiative in Central and South America has encouraged efforts to eliminate rabies in other countries. In the early part of the current century, a WHO-promoted project set out to estimate the human rabies burden in India. In 2004, the project estimated that there were 20,000 human cases a year in India and around 15.6 dog bites per 100,000 people. India has a large population of roaming street dogs (estimated at 60 million or more) and has no centrally organized program to vaccinate them. In fact, until 2021, rabies was not even a reportable disease (where hospitals and medical professionals are required to report all cases to government authorities). Even now, five years later, the Indian Health Ministry only records a small fraction of human rabies cases. However, a recent paper published in The Lancet Infectious Diseases, a leading medical journal, reported that the incidence of dog bites dropped from 15.6 to 5.6 bites per 100,000 people in the 19 years since the 2004 survey. The estimated number of human rabies cases fell from 20,000 to under 6,000 per annum.

The authors reporting this dramatic fall in dog bite rates and human rabies cases did not speculate on plausible causes for these declines. Among people bitten by a dog, 20% did not receive any anti-rabies treatment, while half of those who received at least one dose of an anti-rabies vaccine did not complete the full course of vaccination.

In 2025, Professor Reeta S Mani published an editorial on Indian progress towards rabies elimination to recognize World Rabies Day (September 28, the day Louis Pasteur died). She noted substantial advances in rabies treatment (better vaccines, more effective vaccine administration, more affordable and more widely available post-exposure prophylaxis (PEP) treatments), but also delays in treatment and public misconceptions and ignorance about what to do after being bitten by a dog. She also noted challenges, including inadequate national surveillance and the large population of street dogs.

Nevertheless, she noted the success of local state-led anti-rabies measures, including anti-rabies projects led by international NGOs in the states of Sikkim and Goa that had demonstrated the benefits of dog vaccination and sterilization programs. It should be noted that the animal NGOs, Help in Suffering in Jaipur and the Blue Cross of India in Chennai, had already, early this century, reported benefits of Animal Birth Control (ABC) programs in eliminating human rabies cases in both cities.

In Jaipur, Help in Suffering also reported a two-thirds fall in dog bites following the implementation of the ABC project. Given the expansion of systematic state-wide and municipal ABC projects by local and international animal NGOs, it seems reasonable to suggest that the significant decline in dog bites and human rabies cases in the country could be the result of more effective ABC projects nationwide.

Bhutan and Afghanistan Cases

Bhutan offers a national example of the impact of rabies vaccination and dog sterilization nationwide. While implementing a national dog vaccination and sterilization program in a country with a human population of fewer than a million people is much less of a challenge than in one with a population of 1.4 billion, the principle still holds. In WBI’s opinion, dog vaccination coupled with dog sterilization is an effective and economical approach to reducing and eliminating human rabies in a country. The benefits of such an approach were apparent to the Taliban after they took control of Afghanistan. A British NGO, Mayhew Afghanistan, had been surveying, vaccinating and sterilizing dogs in Kabul for almost 10 years. Once the Taliban recognized the project’s benefits, they invited the NGO to resume its operations.

Conclusion

There are other successful dog vaccination and sterilization projects. The United Nations Development Programme (UNDP) has embraced sustainable dog population management and is supporting anti-rabies initiatives in India. Professor Mani noted in her editorial that “rabies elimination by 2030 is a formidable challenge,” but WBI believes that India is already making significant progress toward that goal. As states and municipalities expand partnerships with local and international NGOs and funding agencies to implement systematic dog population surveys, rabies vaccination campaigns, and sterilization programs for both owned and roaming dogs, India could match Bhutan’s achievement and become an inspiration for countries across Asia and Africa that continue to struggle with human rabies.

While eliminating human rabies is a very important goal, WBI would like to note that eliminating human rabies will also benefit dogs and other mammals who will be saved from the suffering they experience from the disease.