22-year-old Bale Hasda, who goes by the name Sumi, was bitten by a stray dog in Delhi’s upscale Lodhi Colony on 11 March. She wasn’t the only victim, or even the worst affected. A few others in the neighbourhood were bitten as well, with one senior citizen dying as a result of the dog attack.
Fortunately for Sumi, her employer rushed her to Delhi’s Safdarjung Hospital, one of the few public health centres in the national capital that still have stocks of the vital anti-rabies vaccine (ARV). As ARV supplies at other public hospitals dry up, Safdarjung Hospital has seen its anti-rabies clinic overwhelmed with victims of dog bite cases.
Sumi received a tetanus injection and a shot of the life-saving rabies immunoglobulin—a serum administered for deep animal bites and scratches—and also a series of five ARV injections over the next few days. The last of these injections was on 8 April, nearly a month since her ordeal began. All told, the treatment cost her Rs 3,000 ($44), while the serum was given free of cost. At a private healthcare provider, this could have cost as much as Rs 15,000 ($218).
Without timely medical intervention and the availability of the ARV, Sumi’s story could have panned out very differently. Others have not been as lucky, turned away from their closest public hospitals due to the non-availability of the ARV in Delhi. Elsewhere in the country, the situation is equally dire. Karnataka, Jammu and Kashmir, and Punjab among various other states are all running out.
That this would be the case in India is a bit of an oddity because literally nowhere else is the need for ARV more obvious. India accounts for 36% of deaths due to rabies worldwide. Some 20,800 deaths every year, most of them children under the age of 15, according to a 2015 study published in the PLOS Neglected Tropical Diseases journal.
India is also home to the largest anti-rabies vaccine manufacturer in the world—formerly GSK-owned Chiron Behring Vaccines, which has now been acquired by Bharat Biotech.
On its own, Chiron Behring’s facility had a capacity of 15 million doses, almost a third of the national yearly requirement of 35-48 million doses. In fact, India’s four ARV manufacturers—Hyderabad-based Bharat Biotech and Indian Immunologicals Ltd, Ahmedabad-based Cadila Healthcare, and Pune’s Serum Institute of India (SII)—have a combined capacity of 40-50 million doses annually.