Going to the dogs

Pakistan is the only country producing and administering 'sheep brain' vaccine for treatment of rabies.

ISLAMABAD: Pakistan is the only country in the world to produce and administer ‘sheep brain’ vaccine for the treatment of rabies, a concoction that was declared harmful and ineffective by the World Health Organisation in 1994.

The vaccine, made from sheep brain cells,  is being manufactured by the National Institute of Health, Islamabad, and provided to Basic Health Units and government hospitals across the country.

It has serious side effects that could also lead to the invariably fatal brain disorder Creutzfeldt-Jakob among people who are transfused blood from an innoculated person.

“WHO has endorsed  ‘tissue culture’ vaccine  as an alternative method;  unfortunately, it isn’t common in Pakistan because of its high cost,” said Dr Shahab Qazi, national coordinator for the Rabies Prevention and Control Programme at the National Institute of Health (NIH).

Every year, around 115,000 people are infected with rabies throughout Pakistan, according to the Ministry of Health. September 28 is marked as World Rabies Day in the country to create awareness about the impact of human and animal rabies, its prevention and eradication.

But amid blame shifting and claims of lack of funds, serious concern is being raised over the Ministry of Health’s ineffectiveness in controlling the disease; from allowing the sheep brain vaccine to be manufactured despite its widely acknowledged side effects to keeping rabies control programmes on the back burner.

The Rabies Immune Globulin, which WHO recommends as life saving in severe wounds, is almost unheard of in most government hospitals and almost all Basic Health Units in the country, said Dr Naseem Salahuddin, president Rabies in Asia Foundation Pakistan chapter and member of the expert panel on rabies at WHO. No training is imparted to health staff dealing with the disease as well, she added.

“Despite being a serious viral condition, rabies is being treated as an orphan disease by the ministry,” said Dr Salahuddin,

The neglect has led to the crippling of an awareness project initiated in 2000 on the disease and its prevention.

“The Ministry of Health was supposed to release $ 32,000 to NIH every year for the country-wide campaign, but since the last two years we have not received a single penny,” said Dr Qazi.

Consequently, the Rabies Prevention and Control Programme at NIH is in limbo.

Dr Qazi said NIH had requested the ministry for the funds many times in the last two years, but had not received a response. Meanwhile, Dr Rashid Jooma, director general Ministry of Health, denied that the ministry had been contacted by NIH in this regard.

Dr Jooma acknowledged that sheep brain vaccine is being manufactured and used in the country. “It is because we do not have the technology to produce tissue culture vaccine,” he said. But he denied that WHO had declared sheep brain vaccine as obsolete. He said it is recommended by all executive district officers (health) in the country.

Meanwhile, some 5000 people die of the disease in the country every year, according to Dr Qazi.  Around ten people go to the emergency department in PIMS and Poly Clinic hospitals everyday after being bitten by dogs.

Infected animals are common in the rural areas of the capital, said Shamsul Haq, director sanitation Capital Development Authority. “We kill around three dogs infected with rabies everyday,” he said.

Published in The Express Tribune, September 28^th, 2010.