RABIES is a disease so cruel that it defies imagination. There is no cure once symptoms appear. Yet the paradox is that rabies is one of the world鈥檚 most preventable diseases. Awareness, timely vaccination and a systemic approach that unites human health, animal health and the environment 鈥� the essence of the 鈥榦ne health鈥� philosophy 鈥� are enough to consign rabies to history. If the tools exist, then why does the disease persist in Bangladesh? The answer lies not in science but in the failures of our health system, our governance and our societal attitudes towards animals.
The theme of this year鈥檚 World Rabies Day, 鈥楢ct Now: You, Me, Community,鈥� calls for immediate, collective action. But in Bangladesh, action has too often been piecemeal. The National Rabies Elimination Programme, launched in 2011, brought real progress: modern intradermal vaccines replaced outdated nerve-tissue vaccines; bite management centres began providing post-exposure prophylaxis free of charge; and mass dog vaccination campaigns were initiated. These were historic steps forward. Between 2011 and 2022, more than 2.8 million people received life-saving vaccines and recorded rabies deaths declined. Yet during the same period, 724 lives were still lost, evidence that the system is not yet strong enough, and that its weakest links continue to cost human lives.
The persistence of rabies despite these gains points to systemic gaps. Vaccine shortages in rural areas, weak cold-chain systems, delays in access to rabies immunoglobulin, and lack of awareness all play their part. A hospital-based study recently showed that only a fraction of bite victims in Bangladesh receive the full World Health Organisation recommended protocol, including immediate wound washing, complete vaccination, and rabies immunoglobulin where required. Children, who make up around 40 per cent of victims, are especially vulnerable. They are often bitten while throwing stones or teasing dogs and may not understand the urgency of seeking medical care. When the system fails to provide swift, reliable access, these lapses turn fatal. Rabies is just not confined to dogs, and our current systems of public communication and response remain deeply inadequate. When a preventable disease continues to claim lives in such ways, it reveals more about our failures than about the pathogen itself.
There is also the question of how Bangladesh manages the animals at the heart of rabies transmission. For decades, the reflex was mass dog culling, an approach that was both inhumane and ineffective. Humane methods are now recognised as global best practice: the catch-neuter-vaccinate-release model, which stabilises dog populations, reduces aggression and maintains high levels of vaccination coverage. Yet here too progress has been sluggish. Programmes remain underfunded and limited in scope, leaving many urban and rural areas untouched. Without sustained catch-neuter-vaccinate-release and mass dog vaccination covering around 70 per cent of the population, rabies will remain endemic. Cruelty, moreover, cannot be the price of public health.
There is no shortage of knowledge. The World Health Organisation, the Food and Agriculture Organisation, and the World Organisation for Animal Health have for years stressed that rabies elimination is feasible through the One Health approach. Time-series modelling even suggests Bangladesh could eliminate dog-mediated human rabies by 2030 if current interventions are strengthened and sustained. The problem is political will and institutional commitment. Rabies has never been prioritised in the way tuberculosis, dengue, or polio have been. Its victims are mostly poor, rural, or marginalised, which makes their deaths less visible in national discourse. This silent tragedy is perpetuated by neglect.
So what must change? First, vaccine access must be universal. Every upazila should have at least one fully resourced bite management centre with reliable cold-chain facilities. Rabies immunoglobulin must be prioritised for procurement and distribution. A real-time digital dashboard should monitor vaccine stock levels nationwide to prevent shortages. Second, catch-neuter-vaccinate-release programmes need rapid expansion, with trained humane-handling teams, veterinary support and community involvement. Third, surveillance must be integrated. The integrated bite case management system is a start, but it requires consistent funding, wider adoption and laboratory capacity for real-time confirmation. Predictive modelling can then guide resources to high-risk districts.
Public awareness is equally vital. Rabies education must be embedded in primary school curricula: friendly and safe behaviour around animals, the importance of immediate wound cleaning with soap and water and the necessity of completing the vaccination schedule. Children can, in fact, become the most effective ambassadors of awareness in their communities.听
Bangladesh has shown that progress is possible. Deaths have declined, millions have been saved, and new structures are in place. But the goal must now be elimination. 鈥榸ero by 30鈥�, the global commitment to end dog-mediated human rabies by 2030, must not remain an aspiration on paper. It must be backed by resources, coordination and accountability. Without that, the disease will linger, picking off the most vulnerable, while the tools to stop it lie unused.
The theme of World Rabies Day reminds us: 鈥楢ct Now: You, Me, Community.鈥� That is not a slogan but an instruction. To act means to fund, to coordinate, to educate, to vaccinate and to do so without cruelty. A rabies-free Bangladesh is within reach, but only if we confront our failures honestly and resolve to replace them with humane, collective and sustained action.听
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Professor Dr Md Ahsanul Haque is the director of One Health Institute at Chattogram Veterinary and Animal Sciences University.