Health Experts Endorse Government’s 2030 Rabies Eradication Plan in IHW Council Panel, Advocating Monoclonal Antibodies as an Alternative to RIGs

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Business Wire IndiaOn the 17th annual observance of World Zoonoses Day, a virtual conference organized by the IHW Council under the ‘VIRAM – Full Stop on Rabies’ campaign, brought together eminent health experts to address the urgent challenge of eliminating rabies by 2030. The event featured distinguished participants including Dr. Anurag Agarwal, Founder Secretary of the Consortium Against Rabies (CAR); Dr. Ravish H.S, Professor of Community Medicine at KIMS, Bangalore, and Secretary General of Association for the Prevention and Control of Rabies (APCRI); Dr. M. Sai Surendar, Vice President of the Society for Emergency Medicine India (SEMI); Dr. S Muhammad Salim Khan, Professor & Head of the Department of Community Medicine at Government Medical College, Srinagar; and Dr. Asis Manna, Professor & Head of the Department of Microbiology at Murshidabad Medical College & Hospital.
 
Rabies remains a significant public health challenge in India, accounting for 36% of global rabies deaths and causing an estimated 18,000 to 20,000 fatalities annually, with a disproportionate impact on children under 15. Despite these alarming statistics, rabies deaths are entirely preventable with prompt and complete post-exposure prophylaxis.
 
Speaking at the event, Dr. Anurag Agarwal said “Rabies is 100% preventable with proper post-exposure treatment (PEP). Immediate wound washing, categorization and administration of immunoglobulins are crucial steps following an animal bite.”
 
A major highlight of the conference was the discussion on passive immunization advancements, particularly the development of cocktail monoclonal antibodies to prevent rabies.
 
Dr. Asis Manna explained, “Rabies can effectively be prevented through post-exposure prophylaxis (PEP), which includes vaccines and anti-rabies immunoglobulins (RIGs). Unfortunately, there is currently no treatment available for symptomatic rabies. Implementing PEP protocols in resource-limited settings presents challenges, particularly with access and implementation. These obstacles could be alleviated to some extent by replacing RIGs with cocktail monoclonal antibodies (mAbs). Monoclonal antibodies offer advantages such as lower production costs, reliable supply availability, long-term storage capability, and a superior safety profile compared to conventional RIGs.”
 
The World Health Organization (WHO), in collaboration with its collaborating centres for rabies, has spearheaded efforts to develop and deploy cocktail monoclonal antibodies globally, ensuring equitable access to effective rabies prevention methods, particularly in low-resource settings.
 
Dr. S Muhammad Salim Khan stated, “We’ve been managing 7,000 to 8,000 animal bite cases annually. Initially, we had a budget of one lakh rupees for vaccines, but it has now increased to one crore. This government support has been crucial, allowing us to provide free anti-rabies vaccines and immunoglobulins. We’re also starting to use monoclonal antibodies to some extent and hope to expand this as the budget increases. Recently, the government of J&K made rabies a notifiable disease, which will help us identify and modify rabies cases more effectively. Previously, we had little data on rabies deaths, but with the National Rabies Control Program and the new notification, we expect to have much better national data.”
 
While there are notable developments in tackling rabies in the country, there are numerous challenges that persist.
 
Speaking on the same, Dr. Ravish H.S highlighted that, “Training healthcare personnel on the nuances of post-exposure prophylaxis, including dose awareness, is critical. Addressing challenges in advocacy, adoption, and implementation is essential to enhancing public awareness and ensuring effective rabies prevention strategies. Furthermore, fostering community engagement and education initiatives will play a pivotal role in empowering individuals to seek prompt medical care following animal bites, thereby reducing the incidence of rabies cases.”
 
Dr. M. Sai Surendar was quick to point out that, “Society for Emergency Medicine India, an association actively engaged in saving lives from rabies, is committed to addressing challenges associated with rabies prevention. We are launching several initiatives to raise awareness, educate, and advocate for emergency physicians. Our SEMI mentorship program aims to standardize protocols for animal bite management, introducing a protocol that includes both passive and active immunization. Additionally, we conduct regular group discussions across our state chapters in India, fostering collaborative case study reviews to effectively tackle these challenges.”
 
The Indian government is actively working to eradicate rabies by 2030. The use of cocktail monoclonal antibodies is emerging as a promising alternative to conventional immunoglobulin, addressing related challenges and availability issues.
 
Dr. Anurag Agarwal stresses, “It’s crucial to immediately cleanse the wound with soap and water, seek prompt medical consultation, and ensure completion of the full vaccination regimen after an animal bite to prevent fatal rabies symptoms. These simple yet essential steps can save lives and effectively mitigate the risk of rabies transmission.”