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Eliminating Dog-Mediated Rabies in Sikkim, India: A 10-Year Pathway to Success for the SARAH Program

By Helen Byrnes, Andrea Britton, Thinlay Bhutia

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A third of the world rabies burden is in India. The Sikkim Anti-Rabies and Animal Health (SARAH) program is the first state-wide rabies program in India and demonstrates a successful One Health model of dog-mediated rabies elimination. The SARAH program was created in 2006 as a collaboration between the Government of Sikkim and international non-government organizations—Vets Beyond Borders and Fondation Brigitte Bardot. Activities are directed to canine rabies vaccination, humane dog population control, community education, and treatment of sick and injured animals. In 2005, there were 0.74 human rabies deaths per 100,000 (4 deaths) within Sikkim, and from 2006 to 2015, there were no human rabies deaths. In 2016, two human rabies deaths were reported near the West Bengal border region. From 2005 to 2010, the incidence of animal rabies is unknown; from 2010 to 2016, eight cases of animal rabies were reported. Major challenges for the program are continued commitment to rabies control in the face of 0 to low human rabies incidence and the risk of rabies incursions. Effective intersectoral communication between Health, Veterinary, Forestry, and Police officers is essential to enable rapid response to animal bite incidents and possible rabies incursions. An integrated One Health approach needs to be maintained with enhanced active rabies surveillance. Other states must establish similar programs if India is ever to achieve a goal of eliminating dog-mediated human rabies.


Mason N McLary

HABRI Central

Date 2017
Publication Title Frontiers in Veterinary Science
Volume 4
Issue 28
Publisher Frontiers
DOI 10.3389/fvets.2017.00028
Language English
Additional Language English
Cite this work

Researchers should cite this work as follows:

  1. Animal health and hygiene
  2. Animal roles
  3. Animals in culture
  4. Animal welfare
  5. Dogs
  6. Health
  7. India
  8. Mammals
  9. One Health
  10. Physical environment
  11. population control
  12. Rabies
  13. Social Environments
  14. surveillance
  15. vaccination
  16. Veterinary medicine