Karnataka’s hospitals are grappling with a shortage of the rabies vaccine, with many forced to procure them from other sources.
Rabies is one of India’s most lethal diseases, killing every person it came into contact with in 2017. Since 2010, only six people have survived rabies infections despite the disease being entirely vaccine preventable. Rabies kill 20,847 Indians every year, accounting for one-third of the world’s rabies deaths. The standard treatment is a four-shot course of the anti-rabies vaccine and rabies immunoglobulin, both of which are domestically produced in India. Despite this, hospitals regularly face shortages – as is the case now in Karnataka. As a result, facilities in the state are seeking supplies of the vaccine from other hospitals or the private sector.
The state government is aware of the issue, according to one doctor. “The state government has raised the issue of shortage of ARV with the central government,” said Dr Ranganath T. S., who heads the rabies clinic at Victoria Hospital. “The Drug Controller General of India has been directed to issue letters to the primary manufacturers of the vaccine to increase the supply within 30 days and submit a report on the action taken by them to the central government.” At present, the state government has managed to procure just 250 vaccines from Kerala and Tamil Nadu despite demand for the vaccines exceeding two lakh. Tamil Nadu is among the most prominent suppliers of the rabies vaccine to other states in India, releasing 50,000 vials of the anti-rabies vaccine to Andhra Pradesh and Delhi earlier this year.
Karnataka is far from the only state to witness shortages of the vaccine. In fact, shortages of the rabies vaccine in government-run hospitals can be found in all 35 states and union territories with the deficit varying between twenty and eighty percent. Many seek treatment for rabies in private hospitals as a consequence, where costs range between Rs 350 and Rs 500 for each shot of the vaccine, in addition to the immunoglobulin, which can cost anywhere from Rs 650 to Rs 2,500. Issues with the supply chain have been identified as a primary cause of this and led to suggestions of a more centralised approach to managing the disease being undertaken, as opposed to responsibility being delegated to state governments.
The central government has been involved in efforts to counteract shortages, including capping the number of rabies vaccines produced in India which manufacturers can export. However, more needs to be done to remedy issues within the supply chain to ensure treatment can reach those who need it in a timely and affordable manner. Otherwise, the disease is likely to retain its distinction as one of India’s deadliest.