Doctors call for faster post-exposure care, stronger anti-rabies services and wider access to
newer passive immunisation options

New Delhi, September 30, 2026 : India’s efforts to eliminate dog-mediated human rabies by
2030 could gain further momentum with experts calling for wider access to rabies monoclonal
antibodies (RmAbs) alongside faster post-exposure care, better exposure assessment and
stronger anti-rabies services. The call comes as the World Health Organization recognises
monoclonal antibodies as an option for passive immunisation when indicated as part of post-
exposure prophylaxis, while the 2025 WHO Model List of Essential Medicines includes rabies
monoclonal antibodies for rabies post-exposure prophylaxis.

The call was made during a panel discussion titled “Full Stop on Rabies: Advancing Access to
Post-Exposure Care for Rabies Bridging Gaps in Prevention and Treatment”, organised by the
IHW Council, a public-health advocacy and healthcare ecosystem organisation, and supported
by VIRAM: Full Stop on Rabies initiative under the umbrella of Zydus Lifesciences. The
discussion brought together experts in paediatrics, community medicine, emergency medicine
and infectious diseases from India and Nepal.

Despite being preventable, rabies continues to cause a significant burden in India, with the
latest nationally comparable ICMR-National Institute of Epidemiology assessment estimating
9.1 million animal bites and 5,726 human rabies deaths annually. The study also found gaps in

completion of post-exposure vaccination. Experts said preventing deaths requires accurate
exposure assessment and prompt care, including immediate wound washing, passive
immunisation with RIG or RmAbs where indicated, and completion of the anti-rabies vaccine
schedule.

The panel highlighted rabies monoclonal antibody cocktails as an alternative to rabies
immunoglobulin for passive immunisation, in line with WHO recommendations. While India has
developed and manufactured RmAbs, Nepal has incorporated RmAb cocktails into its national
guidelines. Experts called for wider availability beyond tertiary centres and continued
healthcare-worker training to strengthen access to appropriate passive immunisation.

Prof. Dr. Anurag Agarwal, Professor of Paediatrics, Maulana Azad Medical College, and
Secretary, Consortium Against Rabies, said, “The biggest reason people are dying of rabies is
not just the absence of vaccines. It is the absence of awareness. A child gets bitten, a drop of
blood appears, and the family thinks it is insignificant. That patient needs local infiltration of
Rabies immunoglobulin or Rabies monoclonal antibodies, plus the full vaccine course, don’t

take risk. We endorse the advancement towards Cocktail of Rabies monoclonal antibodies and
have updated our Consortium against Rabies yearly Blue Book accordingly.”

Dr. Ravish H. S., Professor of Community Medicine, KIMS Bengaluru, and Life Member of
APCRI, said, “Only about 70 per cent of physicians correctly distinguish Category II and Category
III exposures. When in doubt, over-treat rather than under-treat. We have repeatedly asked the
Government of India and state health departments to include rabies monoclonal antibodies in
national guidance, and progress is going on. These products are made in India and can expand
access to life-saving care. Several state health corporations have already adopted them to
strengthen access to passive immunisation.” APCRI also endorses Cocktail of Rabies monoclonal
antibodies for passive immunisation.

Dr. Sree Soujanya, Regional Clinical Director for Emergency Medicine at Apollo Hospitals and
President of SEMI , said, “These misconceptions are dangerous. Whenever there is doubt
between Category II and Category III, up-triage the patient. The vaccine takes 7 to 10 days to
generate protective antibodies. Passive immunisation bridges that gap by neutralising the virus
at the wound site. We support the WHO recommendation for monoclonal antibody cocktails.
Their availability can be better, and they can minimise serum-reaction concerns.”

Dr. Sher Bahadur Pun, Physician and Chief of the Clinical Research Unit at Sukraraj Tropical
and Infectious Disease Hospital, Nepal , said, “In Nepal, Our national guidelines already
included Cocktail of Rabies monoclonal antibodies. The challenge now is to ensure that doctors
at district level know how to use them and that access is expanded beyond tertiary centers. The
government has improved their effort in training & access to Post Exposure prophylaxis.

Dr. Manish Kumar Singh, Professor of Community Medicine at Dr. Ram Manohar Lohia
Institute of Medical Sciences and President of IAPSM, said, “A recent Delhi study showed that
41 per cent of patients reached an anti-rabies clinic more than 48 hours after exposure. Minor
scratches and licks on broken skin are ignored. We need model anti-rabies clinics with clear IEC
materials, proper wound-washing areas and healthcare workers trained in correct infiltration
and intradermal vaccination. We support the WHO recommendation for cocktails Rabies
monoclonal antibody as a cost-effective, safer alternative when RIG is unavailable.”

WHO recognises rabies monoclonal antibody cocktails as an option for passive immunisation,
alongside rabies immunoglobulin, when indicated for post-exposure prophylaxis. The panel
called for trained healthcare workers, accurate exposure assessment and reliable availability of
vaccines and rabies biologicals across anti-rabies services, in line with priorities under India’s
National Rabies Control Programme.

Experts urged the public not to dismiss any bite or scratch, regardless of the wound or whether
the animal is a pet. WHO and NCDC recommend washing the wound with soap and water for at
least 15 minutes and seeking medical care immediately. As India targets elimination of dog-
mediated human rabies by 2030, the panel stressed that prompt action after exposure remains
critical to preventing avoidable deaths.