AN ACUTE shortage of anti-rabies vaccine in public hospitals, which include Infectious Diseases Hospital in Dhaka, has created a serious concern, laying bare health services failures. The hospital, which treats 400–500 cases of animal bites a day, ran out of stock on June 27. Hundreds of patients reaching the hospital from outlying areas are turned away. The hospital has also run out of immunoglobulins, used in post-bite treatment, for a month. Hospitals in districts, which provide the vaccine free, report a similar situation, with some having received no supply for three months. The vaccine procurement, earlier overseen by the Directorate General of Health Services, was handed over to the Central Medical Store Depot in June 2024. Since then, the situation worsened. And no new supply reached the hospitals. The government agency received a supply of 80,000 doses from the manufacturer on June 27. The agency, which would send the vaccines to hospitals after a ‘mandatory survey,’ has not, however, explained the delay.
The risk that the vaccine shortage has posed is severe and multifaceted. It exposes both public health and animals to major risks. Rabies is a zoonotic disease with a 100 per cent fatality rate if left untreated but entirely preventable with timely vaccination. Bangladesh ranks among the top three countries for human rabies death. According to the Lancet, rabies carries a high public health burden in Bangladesh, with about 300,000–400,000 people bitten by carrier animals each year. For most patients, public hospitals are the only source of free treatment as the rabies vaccine is expensive in the private sector. The disruption, therefore, affects low-income communities. The prolonged unavailability of the vaccine in public facilities risks reversing the progress made under the National Rabies Elimination Programme, initiated in 2011 with a goal of zero death by 2030. The situation also raises concerns about procurement process. Transfer of responsibilities from one to another agency without ensuring continuity in vaccine supply indicates a lack of coordination. The shortage may also lead to increased animal cruelty, with frightened communities reacting by killing stray dogs, undermining humane population control strategies. This highlights gaps in hospital management, forecasting and supply chain integrity in a public health system that is expected to respond to preventable diseases with efficiency and care.
The authorities should, therefore, urgently distribute the vaccines to high-risk hospitals and revise the procurement for timely purchase, decentralised forecasting and buffer stocks. Public hospital preparedness needs a review to ensure uninterrupted post-exposure treatment. Sustaining the rabies elimination goal demands consistent human and animal vaccination, strong inter-agency coordination and accurate data on animal bites. Delay risks preventable death and undermine public health and disease control.
