The Question of Availability of Rabies Biologicals

Most of the available rabies vaccines are indigenously produced in the country. The rabies vaccines are procured by the state governments - the scenario of their availability varies from 24 × 7 availability in Gujarat and Kerala, to occasional supplies in Manipur and Bihar. In fact, there is a 20-80 per cent shortage in anti-rabies vaccines across all States, barring Kerala and Gujarat. However, this is contradicted in an article in 2019, that stated that rabies vaccines had been in short supply in Ahmedabad for nine months.

A 2018 article said that India sees 1.75 million dog bites every year, yet we face up to 80% shortage of anti-rabies vaccines. The government is dragging its feet over controlling dog population, vaccinating them or even making enough shots available for victims.

There was no immunoglobulin for almost a month in Panaji in March 2015. 

Manufacturers remained cold to three tenders floated by Karnataka in 2019 and the State Government had to seek help from neighbouring States. Kerala government responded by providing 10,000 shots of anti-rabies injection and 2,000 vials of immunoglobulin injection.

Recent reports suggest that human rabies vaccine shortage is a common problem also in Punjab (it is a problem even in Delhi Government hospitals, as this report of 2019 shows). 

Rabies biologicals, i.e., vaccines and immunoglobulins are life saving for humans in all rabid animal exposures. These biologicals should be continuously available throughout the year, in the entire country to prevent human rabies.

A 2018 article said that while on the one hand the production is low, states are not procuring enough either due to shortage of funds or maladministration. There is an urgent need for central procurement of rabies vaccines.

In Sep 2019, manufacturers and marketers informed that lack of firm orders by State governments and late payments led to the shortage. The Health Ministry advised State governments to issue quantity based tenders and place long-term firm orders with specific quantity and supply schedule.

A welcome news late in 2019 was that a Gujarat-based plant of Rabies vaccines, shut for a few years, was re-starting production. It had commanded the lion's share of the vaccines market previously. 

Shortages were also caused from Aug 2018 onwards when a major rabies vaccine maker based in China was caught out for fraudulent practices in their manufacture. He had to withdraw vaccines from the market (including those exported to India) and subsequently shut down. 

Looking at reports further back, even in 2008, it was said that the post treatment immunoglobulin was almost impossible to obtain in most of India.