Market mapping and landscape analysis of human rabies biologicals in India.

BACKGROUND: Rabies vaccines and immunoglobulins are lifesaving in humans following animal exposures. These biologicals should continuously be available throughout the year to prevent and eliminate human rabies by 2030. OBJECTIVES: The present study aimed at assessing availability of different kinds of human rabies biologicals in the country and undertaking market mapping and landscape analysis of human rabies biologicals in India. METHODS: The study comprising both quantitative and qualitative approach was conducted from May to November 2017 as a part of the Indian multicentric rabies survey by Association for Prevention and Control of Rabies in India. All stakeholders (agencies/personnel) associated with rabies biologicals were the study units/participants. Required data were generated through brainstorming sessions with key stakeholders; reviewing of databases/existing literature; conducting in-depth surveys; interviewing; focused group discussions, etc. RESULTS: Two types of cell culture rabies vaccines are available in the country manufactured by different pharmaceutical companies; most of the vaccines are indigenously produced and the market size of the rabies vaccines is about INR 125 crores with highest sales in the northern region followed by South. Likewise, there are 2 types of immunoglobulin available, i.e., equine rabies immunoglobulins (RIGs), which are indigenously produced and human RIGs, which are imported. The market value of RIGs is about INR 83 crores. A novel rabies monoclonal antibody is also been marketed in the country from November 2017. CONCLUSIONS: There are many lacunas in the market availability of rabies biologicals in different parts of the country; therefore, a significant expansion/shift in focus must be considered, through rigorous strategic planning process.

Assessing rabies-free status of Andaman, Nicobar, and Lakshadweep Islands, India.

The Indian Islands of Andaman, Nicobar, and Lakshadweep have been historically rabies-free. However, reliable laboratory evidence to substantiate rabies-free status was lacking. In this background, the study was conducted as a component of the World Health Organization-Association for Prevention and Control of Rabies in India, Indian Multi-Centric Rabies Survey; to assess the rabies-free status of the two Islands and to examine the feasibility of initiating laboratory surveillance for rabies in dogs in Andaman, Nicobar, and Cats in Lakshadweep Islands. A team of medical and veterinary investigators visited these Islands in 2017. A review of 10 years records (2007-2017) in medical and veterinary institutes and interviews with different stakeholders were conducted. Based on the review of records, there was no evidence of human/animal rabies in the Islands. Eight dog brain samples from Andaman, Nicobar Islands, and ten cat brain samples from Lakshadweep Islands were tested negative for rabies by fluorescent antibody test at two rabies diagnostic laboratories at Bengaluru.