Controlling rabies

No one should die of rabies in 2026. It is among the deadliest diseases known to medicine, yet it is also among the most preventable. That Sindh has already recorded 19 rabies deaths this year – with the latest victim an eight-year-old boy from Badin – is therefore an administrative failure, not a medical one. The state continues to fail victims long before they reach hospital.

The tragedy is that the province is not unfamiliar with the disease or the measures needed to prevent it. But for years, Sindh's response has been characterised by grand announcements followed by inconsistent implementation. New anti-rabies centres are inaugurated and assurances are repeatedly given that medicines are available. Yet families continue to travel from one health facility to another searching for treatment. Medicines locked away in tertiary hospitals offer little comfort to patients bitten hundreds of kilometres away. The recurring shortages are especially difficult to justify because demand is hardly unpredictable. Sindh records hundreds of thousands of dog-bite cases every year. The government knows where the hotspots are and has years of data to estimate the quantities of vaccines and immunoglobulin required. The government must therefore look to build a robust supply chain capable of meeting a foreseeable demand. At the same time, the province continues to lose ground in controlling the source of the disease. Stray dog populations have expanded across urban and rural Sindh. Municipal authorities often resort to culling after a particularly horrific attack, only to abandon the exercise once public attention fades. Such campaigns have repeatedly failed because they treat the symptom rather than the cause.

Countries that have successfully eliminated human rabies have done so by vaccinating dogs on a large scale while strengthening surveillance and improving access to post-exposure treatment. There is little reason Sindh cannot pursue the same path with equal commitment.