Mint Explainer: The concerns around India's rabies vaccine supply

Mint

2 days ago

A six-year-old's death in Delhi recently due to a dog bite prompted a Supreme Court directive that has sparked widespread furore.
On Monday, the apex court directed municipal authorities to pick up and house all stray dogs in Delhi and parts of the National Capital Region (NCR) in dedicated shelters within eight weeks. This led to widespread outrage among citizens and animal advocacy groups who are concerned that the order may set a precedent for other cities and towns. On Thursday, the top court reserved its order on a plea seeking an interim stay on the 11 August order.
To be sure, India has one of the highest burdens of rabies deaths globally, with dog bites being the primary cause. An estimated 5,700 people die from dog-mediated rabies annually in India, according to a 2024 Lancet study. A national plan to eliminate rabies caused by dog bites by 2030 is still underway, but the country has made significant strides in reducing cases.
Amid the ongoing controversy, Mint takes a look at India's rabies vaccine market and examines how access is shaping up.
The plan
In accordance with the WHO's 2015 call to eliminate dog-mediated rabies by 2030, the Indian government in 2021 announced the National Action Plan for Rabies Elimination (NAPRE), which aims to eliminate dog-mediated rabies from the country by 2030.
Under NAPRE, the state has issued a set of guidelines for states and stakeholders to develop their own action plans, and aims to reduce rabies risk through sustained mass dog vaccinations, pre- and post-exposure prophylaxis, and public education.
Continued availability of the anti-rabies vaccine (ARV) and rabies immunoglobulins (RIG) is key to eliminating human rabies by 2030, a 2019 research paper by the Association for Prevention and Control of Rabies in India (APCRI) noted.
The rise and drop in cases
According to a fisheries, animal husbandry and dairying ministry press release, dated 1 April 2025, dog bite cases and deaths across the country have increased from 2022 to 2024.
In 2022, the country reported close to 2.2 million cases. In 2023, this increased to 3.05 million, in 2024 to 3.7 million. In January 2025, there were over 400,000 reported cases of dog bites.
Human deaths from rabies grew from 21 in 2022 to 50 in 2023 and 54 in 2024, according to the release. In January 2025, there was one reported case of death.
It is important to note that many cases of dog bites go unreported due to a lack of awareness, and as people often don't get vaccinated in time.
A recent study backed by the Indian Council of Medical Research (ICMR) and published in The Lancet, noted that India has made significant strides in reducing rabies-related deaths.
In the past two decades, India has witnessed a 75% decline in dog-mediated human rabies deaths, most likely due to the increased availability of ARV and RIG in the health facilities, the study, which surveyed 534 health facilities across 60 districts in 15 states, stated.
Is there a shortage of vaccines?
According to the Lancet study, a majority of public healthcare facilities in India maintained stocks of anti-rabies vaccines. They were found in 80% of the facilities and 90% of secondary and tertiary care centres. Meanwhile, 95% of district hospitals and 92% of medical colleges had stocks.
However, what is lacking is the availability of rabies immunoglobulins. Four out of five facilities surveyed lacked immunoglobulin stocks. The largest shortage was at the primary care level, where over 94% facilities lacked supplies.
Immunoglobulins are administered around the wound to neutralise the virus, especially in cases of severe bites. This is followed by the administration of a series of 4-5 rabies vaccine shots over a period of 28 days. The course of treatment is decided based on the severity of the wound and the status of the animal.
Immunoglobulins are critical in arresting the spread of the virus and preventing death.
Reports of shortages in states and cities persist. Earlier this month, Times of India reported a shortage of vaccines in BMC-run hospitals in Mumbai. Chennai reported a shortage in June 2025.
There is no shortage in the supply of vaccines, a National Centre of Disease Control (NCDC) official told Mint on the condition of anonymity. However, given that it is a decentralised procurement system, where states are allocated funds and procure vaccines on their own, there could be issues.
In instances of disproportionate increase in animal bite cases, there may be issues with appropriate prediction and stocking at the state level, the official said.
The central government released ₹68.86 crore in funds for procurement of vaccines to states in FY21. In FY22, ₹62.33 crore, ₹98.75 crore in FY23 and ₹99.77 crore in FY24, according to the Ministry of Health and Welfare's written Rajya Sabha reply in December 2023.
Who makes these vaccines?
India is one of the largest manufacturers of rabies vaccines globally, and most of the country's needs are met by indigenous products. Geographically, supply is 85% concentrated in China and India, a WHO global market study on human rabies vaccines from 2020 pointed out.
There are currently ten manufacturers of anti-rabies vaccines in the country. The top selling brands are Rabivax by Serum Institute of India (SII), Abhayrab by Indian Immunologicals, and Chirorab by Bharat Biotech, according to data from pharma intelligence platform Pharmarack. Other players include Sun Pharma, Mankind Pharma, and Zydus Cadila.
However, there are only four immunoglobulins manufactured in India - two by Mankind and two by Indian Immunologicals and Serum Institute which have a negligible market share. There are two types of immunoglobulin available–equine rabies immunoglobulins (RIGs), which are indigenously produced, and human RIGs, which are imported.
Human RIGs are considered to be safer and more effective, especially in children, according to studies.
The overall market for rabies vaccines in India was ₹266 crore in July 2025 on a moving annual total basis, according to Pharmarack, a B2B e-commerce platform. Of this, ₹240 crore was for ARVs and ₹25 crore for immunoglobulins.
A total of 7,593 units of both ARV and RIG were sold as of July 2025. The number of units sold monthly has remained steady between 2023 and the current date, with a slight uptick in recent months, the data showed.
Cost remains an issue in accessing rabies vaccines as well. While they are provided free of charge in public facilities, the cost of one vial of ARV is typically between ₹350 and ₹400 in private hospitals.
According to the WHO, the cost of post-exposure prophylaxis (PEP), the regimen of human RIG and ARV administered after the bite, is the highest in Asia.