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Introduction

Rabies is a historically significant zoonotic disease that results in ~59 000 human deaths annually and causes millions of animal fatalities every year.1 Despite great strides by different countries to control rabies, these initiatives have not always fetched intended results. Still in South Asia, particularly in India, the disease accounts for ~36% of global human rabies deaths.2 Nepal and India both are endemic to rabies3 and in recent years, Nepal has experienced unprecedented rabies outbreaks, especially in regions near the Indian borders.4 This situation has raised concerns that existing rabies control programs in India and Nepal have not fully addressed the underlying issues affecting rabies control, with cross-border challenges being often overlooked.

The open border between Nepal and India facilitates the movement of both humans and animals, which can contribute to the spread of rabies. Many areas along the border are occupied by national parks and wildlife reserves, which support the movement of domestic and wild animals, potentially facilitating the transmission of rabies between the two countries. Although both Nepal and India have implemented their own rabies control plans and policies,5,6 the absence of coordinated cross-border rabies control measures presents significant challenges. Effective rabies control in one country alone is insufficient, as the disease can spill over into neighbouring country, leading to outbreaks. This suggests that a cross-border control strategy is essential for managing rabies effectively. Furthermore, travellers from rabies-free or rabies-eliminated countries visiting India and Nepal should ideally receive vaccination, as both countries are classified as high-risk areas for rabies.3 It is a standard practice to immunize travellers against disease before they visit high-risk regions.7 Nepal and India can benefit from the experiences of Indonesia which has successfully prevented and controlled rabies in its international tourist destinations.8

Issue Section:
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