Most of us have heard of rabies often through warnings about stray dogs or from fading posters at local clinics. Yet, what many don’t realise is that this nearly 100% preventable disease still claims close to 60,000 lives every year, with Asia and Africa carrying the greatest burden. India alone accounts for a significant share of these deaths.
Rabies spreads primarily through the saliva of infected animals, with dogs responsible for 99% of human cases. Children are especially vulnerable as they play near stray dogs, may not report bites, and parents often underestimate the seriousness of small scratches or nips. But even seemingly minor scratches or small bites warrant immediate medical attention.
Rabies is deceptive. After a bite, the virus travels silently through the nerves. By the time symptoms such as anxiety, paralysis, or difficulty swallowing appear, treatment is no longer effective. Families often mistake these early signs for other illnesses, losing critical time.
The tragedy is that rabies is entirely preventable. If treated promptly, rabies can be completely prevented through Post-Exposure Prophylaxis (PEP). According to WHO, PEP requires immediate and thorough wound washing with soap and water, followed by rabies vaccination (either intradermal or intramuscular regimens). For category III exposures such as deep bites, multiple bites, or bites to the head/neck, rabies immunoglobulin (RIG) must also be administered promptly. In addition to PEP, WHO also recommends pre-exposure prophylaxis (PrEP) for high-risk groups such as veterinarians, laboratory staff, and children living in highly endemic regions, as it simplifies PEP and provides added protection. Yet many people delay treatment or never seek it at all. Delays, however, cost lives. Sometimes it’s because they don’t know the risks, sometimes because clinics are far away, or simply because of the cost.
The One Health approach to rabies recognizes that rabies is not only a human health issue but also an animal and environmental health issue. The strategy integrates veterinary health (mass dog vaccination, dog population management), human health (bite management, vaccines, post-exposure prophylaxis), and environmental/ community measures (awareness, surveillance, safe waste management to control stray dog populations). Additionally, effective waste management and community-based dog population control reduce the number of unvaccinated strays. Evidence shows that combining vaccination with responsible ownership and ecological management is essential for long-term rabies elimination. This coordinated framework ensures that rabies transmission is tackled at its root in animals while also protecting people.
One Health depends on robust surveillance to track rabies in both animals and humans, confirm cases quickly, and direct vaccination and control measures. Here, diagnosis becomes a roadblock. Most tests need advanced labs and trained professionals, which are missing in semi-urban and rural regions where rabies deaths are highest. As a result, cases go undiagnosed or are confirmed only after it’s too late. While WHO currently recommends DFA and RT-PCR in reference laboratories as gold standards, Truenat extends molecular diagnostic capability to decentralized settings and strengthens surveillance where central labs are inaccessible. The Truenat Rabies test addresses this gap by bringing molecular RT-PCR testing to district labs or even field locations. By supporting both veterinary and human rabies surveillance, Truenat strengthens the core surveillance pillar of the One Health approach, allowing programmes such as those in Goa to respond swiftly and contain outbreaks.
Awareness is still the most important tool. Every dog bite, big or small, needs medical attention. Community programmes, posters in local clinics, and school awareness activities can all serve as reminders for families to get medical help immediately after a dog bite, instead of waiting for signs or symptoms to appear. At the same time, accurate diagnostics like Truenat® Rabies play a critical role in the larger prevention framework—helping confirm cases in symptomatic individuals, guiding outbreak investigations, and supporting surveillance in both animals and humans.
Integrated Strategies for Rabies Control and Elimination
If the global community is serious about the “Zero by 30” mission– meaning, no human deaths from dog-mediated rabies by 2030, then the fight has to go beyond hospitals and labs. The “Zero by 30” mission is an aspirational WHO target that will only be achievable with sustained investment in mass dog vaccination, reliable vaccine and RIG availability, and strong community engagement. Rabies is a zoonotic disease, which means human and animal health are closely tied. That’s why the One Health approach, bringing together doctors, veterinarians, policymakers, and communities, is so critical.
One of the strongest tools we already have is dog vaccination. Studies show that sustained vaccination covering ~70% of dogs disrupts transmission and has driven large declines when consistently implemented. On the human health side, clinics must be prepared. Bite victims shouldn’t be turned away because vaccines or rabies immunoglobulin aren’t available. Training frontline workers so they can guide families on what to do immediately after a bite is equally important.
Truenat® Rabies is more than just an added layer of protection—it provides the ability to detect rabies virus in antemortem human samples such as saliva, CSF, or nuchal skin biopsy with high sensitivity, and in postmortem brain tissue for confirmation. This rare breadth of specimen compatibility makes early confirmation possible where it is most challenging. By enabling rapid and reliable diagnosis, Truenat not only supports clinical management but also allows health teams to identify outbreaks early and direct control measures where they are most needed.
Although the efforts are to no avail without steady investment and political will. Governments need to put funds into vaccination drives, healthcare access, and diagnostic support. Communities, too, must step up by vaccinating their own dogs, practicing responsible ownership, and treating every bite as an emergency.