National Rabies Control Programme

National Action Plan for Dog Mediated Rabies Eliminiation from India by 2030 (NAPRE) 

National Rabies Control Programme (NRCP)

Background: Rabies is responsible for extensive morbidity and mortality in India. The disease is endemic throughout the country. With the exception of Andaman & Nicobar and Lakshadweep Islands, human cases of rabies are reported from all over the country. The cases occur throughout the year. About 96% of the mortality and morbidity is associated with dog bites. Cats, wolf, jackal, mongoose and monkeys are other important reservoirs of rabies in India. Bat rabies has not been conclusively reported from the country.

To address the issue of rabies in the country, National Rabies Control Programme was approved during 12th FYP by Standing Finance Committee meeting held on 03.10.2013 as Central Sector Scheme to be implemented under the Umbrella of NHM .The Programme had two components – Human and Animal Components in 12th FYP. Human  Component for roll out in the all States and UTs through nodal agency NCDC with total budget of Rs 20 Crores  and Animal Health Component for pilot testing in Haryana and Chennai  through nodal agency Animal Welfare Board of India(AWBI)under the aegis of MoEF&CC, GOI with total budget of Rs 30 Crores for the Plan period. The Human Health Component has been rolled out in 26 States and UTs (Pilot Project for Animal Health Component by AWBI has been ended with closure of last FY of 12th FYP i.e. with effect from 31.3.2017)

Objectives:

1. Training of Health Care professionals on appropriate Animal bite management and Rabies Post Exposure Prophylaxis.
2. Advocacy for states to adopt and implement Interdermal route of Post exposure prophylaxis for Animal bite Victims and Pre exposure prophylaxis for high risk categories.
3. Strengthen Human Rabies Surveillance System.
4. Strengthening of Regional Laboratories under NRCP for Rabies Diagnosis.
5. Creating awareness in the community through Advocacy & Communication and Social Mobilization.

Activities undertaken in last one year ( 2018-19 )  under NRCP –

• Training and capacity building - Under the programme to review the activites undertaken by the states review Meeting of State Nodal Offciers ( SNOs )  and Training of Master Trainers & under National Rabies Control Programme (NRCP) was held on  11^th October and 12^th October 2018. States were advocated in the meeting to put emphasis  on rabies surveillance and ensuring the availability  of ARV and ARS for animal bit victims. State level Training plans on Animal Bite management and Rabies prophylaxes, Surveillance received from 6 States and training of medical officers and health workers are being conducted across the states. All states and UTs have designated Nodal Officers for NRCP& District Nodal Offices is being appointed in 7 states. To standardize the trainings under NRCP, Technical Committee of experts has been formed for developing Modules and following training modules are being prepared-Training module for the  Medical Officers,Training module for the Health workers, Manual for Rabies diagnostics.

• Guidelines and techncial support to states- To review the recent WHO recomondation on Rabies post exposure propohylaxis ( 2017 ) expert group meeting on Revision of National Guidelines for Rabies Prophylaxis held at NCDC on 8^th January, 2019 & minutes were circulated to stakeholders Review of Rabies control in the state of Goa under the Mission Rabies was underken in oct. 2018.

• Rabies and animal bite surveillance- The standard cases definition on suspected, probable and confirmed cases has been finalized in the expert group meeting held at NCDC. The probable case definition for suspected human rabies has been included under IDSP. Apart from this programm is also mapping and networking of tertiary care hospital (Infectious disease hospitals/Medical College, District Hospital etc.) in the States and Districts. Reporting formats on Animal bite, rabies, laboratory surveillance are being finalised to standardize the reporting  Process for Rabies as a notifiable disease initiated.

• Laboratory strengthening for rabies diagnosis- Four regional laboratories has been supported under the programme to Strengthening Rabies Diagnostics(  National Institute of Mental Health and Neurosciences (NIMHANS), Disease Investigation Unit Lab, Directorate of Animal Husbandry and Veterinary Services,Government of Goa, Panaji, Goa, AIIMS Jodhpur, National Center for Disease Control (NCDC), Delhi ) Review meeting of above labs conducted on 12 thOct 2018. For further labs. Strengthening in the country regional workshops are planned for Medical & Vet. Microbiologists.NIMHANS  banglore organised the workshop in March 2019 and more 30 microbiologist were trained during the workshop from 4-5 states.

• IEC activites - Under the Programme Prototype IEC material was developed and disseminated to the States. World Rabies Day is observed on 28th September each year at NCDC and States were advocated to observe it at State/District level as per the theme of Audio and video spots were created and maass media comapign was conduected for 10 days for generating community awrnesss on rabies from 25 sept to 4 oct 2018.

• Interectoral coordination for Rabies control- To institutionalize the “ONE HEALTH”approach at National level – Collaboration with  DADF, Ministry of Agriculture and Farmer Welfare (MoA&FW) for development of technical guidelines for animal component of rabies control has been done. MoU is proposed to be signed between DADF, MoA&FW, MoH&FW, Wild life institute of India for prevention and control of Zoonotic Disease in India including rabies. 14 States constituted State Level Zoonosis Committee (SLZC) for intersectoral coordination for prevention and control for zoonosis including Rabies. SOPs for institutionalizing One Health approach for Rabies is under process.

• Operationl research - Preliminary meeting on study on assessment  of Rabies burden in the country held with stakeholders ( NIE Chennai, APCRI )  at ICMR on 28^th December, 2018.

Snapshot of Trainings and training under NRCP : 11 th and 12 th oct 2018