Moore, Deborah and Hampson, Katie and Lembo, Tiziana and Rodrigues, Rebecca and Vanak, Abi Tamim and Cleavelan, Sarah (2022) Where Rabies Is Not a Disease. Bridging Healthworlds to Improve Mutual Understanding and Prevention of Rabies. Frontiers in Veterinary Science, 9.

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Abstract

Rabies constitutes an important public health concern and causes an estimated 59,000 human deaths, with the highest burden falling on the rural poor of Asia and Africa (1). This viral infection is usually transmitted through animal bites, mostly from domestic dogs, and is fatal once clinical signs appear (2). Based on the One Health concept that recognizes the interdependence between human and animal health, the global strategic plan to end human deaths from dog-mediated rabies by 2030 (“Zero by 30”) consists of vaccinating dogs to stop transmission at its source, providing post-exposure prophylaxis (PEP, which uses rabies vaccine and, in case of severe exposure, rabies immunoglobulin) to exposed individuals, and increasing community awareness about these two measures and dog bite prevention generally (3). In most endemic countries, each of these components faces challenges. The design of mass dog vaccination campaigns is often poorly informed by an understanding of people’s attitudes toward dogs and perceptions around dog vaccination (4); PEP delivery struggles to reach those that need it most (5); and awareness about how to manage dog bites is often low not only amongst the public (6) but also healthcare providers (7). The common denominator of these issues is frequently a disconnect between research and policy (8), hence the design of strategies that are not context-specific (9). India shares one-third of the global human rabies burden (10) and typifies these problems. Despite the high burden of disease, rabies was made notifiable only in September 2021 (11) and therefore its on-the-ground reality is still poorly understood. Inspired by “Zero by 30,” India recently launched its National Action Plan for dog-mediated Rabies Elimination (NAPRE). Enthusiastic about this plan, a Union Minister claimed that “The mere mention of hadakwa [“rabies” in the language of his native State, Gujarat] induces terror in rural areas. They [villagers] will actively help the government in this noble endeavor” (12). Based on worldviews, beliefs, and symbols, faith healing consists of religious and spiritual practices, performed by the patient or an intermediary, to alleviate suffering or restore health. Health is usually understood not only as the absence of disease, but more specifically as the co-presence of physical, mental, and social wellbeing, and can be achieved in several ways (for example, through divine energy, the power of healer’s hands, a process of spiritual growth). In relation to rabies and dog bites, faith healing is usually considered part of traditional medicine, together with the more common, both in India and abroad, application of substances on the wound (13, 14). India also has the unique distinction of having, besides biomedicine, six other official systems of medicine (i.e., Ayurveda, Siddha, Unani, Yoga, Naturopathy, and Homeopathy), the first three of which are used in the field of rabies (15). For example, a previous study found evidence for herbal therapy and “magicoreligious [practices]” being sought by rabies bite victims in 60% of fatal cases in India (10). By influencing individual and community dog keeping practices and concepts of animal welfare, religion also impacts mass dog vaccination, but this aspect of rabies control is rarely studied (16), even by anthropologists (17). For example, people in India feed free-roaming dogs more because of the belief in karma (i.e., good deeds in the current life lead to a happier rebirth) than a genuine concern for dog welfare (4).

Item Type: Article
Additional Information: Copyright of this article belongs to the Nadal, Hampson, Lembo, Rodrigues, Vanak and Cleaveland. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Uncontrolled Keywords: dog bites, dog-mediated rabies, human rabies, faith healing, healthworlds, mass dog vaccination, One Health, post-exposure prophylaxis.
Subjects: A ATREE Publications > G Journal Papers
Divisions: SM Sehgal Foundation Centre for Biodiversity and Conservation > Biodiversity Monitoring and Conservation Planning
Depositing User: Ms Suchithra R
Date Deposited: 21 Nov 2025 06:42
Last Modified: 21 Nov 2025 06:42
URI: http://archives.atree.org/id/eprint/1154

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