In 2008, Nepal recorded 97 rabies deaths; since then, annual fatalities have ranged between 6 and 32. But experts caution that the real numbers, especially in remote areas with limited surveillance, are likely higher.
As the world eyes the 2030 target for eliminating dog-mediated human rabies deaths, Nepal is accelerating efforts to achieve that goal. But health leaders warn that without a major boost in vaccine investment — especially for animal vaccines — the country risks falling short.
Rabies, once contracted and symptomatic, is almost invariably fatal. While the earliest signs—tingling at the wound, fever, nausea—may seem innocuous, the disease rapidly progresses. Patients may develop extreme aggression, difficulty swallowing (hydrophobia), seizures, paralysis, and ultimately succumb to cardiac or respiratory failure, typically within two weeks.
One harrowing case that continues to haunt medical professionals involved a 5-year-old boy from Kathmandu in 2017. The child was scratched by a roaming dog, and at first the injury seemed minor. But weeks later, he began behaving strangely. Despite hospitalization, doctors could not prevent a fatal outcome. The tragedy spurred Dr Sher Bahadur Pun, who treated the boy, to dedicate his career to raising awareness about rabies in Nepal.
Official records show that human rabies deaths in Nepal have steadily declined over the years. In 2008, Nepal recorded 97 deaths; since then, annual fatalities have ranged between 6 and 32. But experts caution that the real numbers, especially in remote areas with limited surveillance, are likely higher.
More than 95 percent of human rabies cases stem from dog bites, making vaccination of dogs and other animals a critical component of prevention.
Nepal’s Roadmap Toward 2030
Nepal has committed itself to the “Zero by 30” initiative—targeting zero human deaths from dog-mediated rabies by 2030. Its broader strategy rests on three pillars:
- Boosting vaccine production, especially for animals
- Scaling up mass immunisation campaigns
- Stepping up public education and awareness about prevention and post-exposure care
Nepal’s first dog vaccination programme launched in 1983, with 22,000 pet dogs targeted in Kathmandu and another 14,000 elsewhere. Over time, Nepal shifted from older nerve-tissue vaccines to safer, cell culture–based alternatives from 2006 onwards. Since 2007, the government has also provided human anti-rabies vaccines free of cost at public hospitals and health centres.
In recent years, the government has distributed over 200,000 vaccine doses free to people exposed to potential rabies infections. And the Department of Health Services reports that better access to post-exposure prophylaxis has played a key role in reducing deaths.
Still, officials concede that the pace of progress is insufficient. “Until and unless we vaccinate the animals, especially free-ranging stray dogs, it’s almost impossible to completely end rabies by 2030,” asserts Dr Pun.
A Small Outbreak and Swift Response
In July 2025, three human rabies deaths occurred within a Chepang community in Dhading district, west of Kathmandu valley. The Chepang are a forest-dwelling indigenous group. The cluster triggered rapid action: health authorities formed a committee, visited households, and found a dog exhibiting aggressive behavior. That dog later died, confirming suspicions.
As a precaution, all 287 residents of the community were vaccinated against rabies, and no further human cases were reported. The incident illustrates the value of a “search and vaccinate” approach—swift response to outbreaks by locating high-risk areas and delivering vaccines. But sporadic outbreaks like these also highlight gaps in routine coverage and the risk of resurgence if vigilance lapses.
The Bottleneck: Limited Vaccine Supply
A major constraint in Nepal’s campaign is the limited domestic production of animal rabies vaccines. The Rabies Vaccine Production Laboratory (RVPL), under the Department of Livestock Services, currently produces around 180,000 doses annually. But experts say this is inadequate to immunize Nepal’s stray dog population, free-ranging animals, and pets.
Meanwhile, human rabies vaccines are imported, with the government allocating about 13 million Nepali rupees (NPR) annually for post-exposure vaccine procurement. Gavi Director of the Epidemiology and Disease Control Division (EDCD), Dr Chandra Bhal Jha, acknowledges that vaccine shortages are routine: last year’s stock of 377,770 vials ran out before the year ended.
Officials argue that unless investments ramp up—especially in expanding vaccine manufacturing capacity—the 2030 target may slip away.
What Must Happen Next
To stay on track for 2030, health leaders and stakeholders emphasize key priorities:
Scale production dramatically: Domestic vaccine production must be expanded manyfold so that Nepal can meet demand for animal vaccination campaigns.
Secure consistent funding: Budget allocations must be predictable and sufficient to maintain stockpiles for humans and animals alike.
Widen coverage to stray dogs: Vaccinating only owned pets is not enough. Free-ranging dog populations must be included in mass campaigns.
Improve surveillance and outreach: Early detection of outbreaks, especially in rural or forested areas, is crucial, along with outreach to marginalized communities.
Sustain public awareness: People must know what to do if bitten, including wound washing, prompt medical attention, and post-exposure prophylaxis.
As Dr Jha puts it: “If we want to end rabies by 2030, we need to invest more in vaccines.”
Nepal’s progress thus far offers hope: human deaths have declined, and bold initiatives like “search and vaccinate” are already in practice. But the final stretch toward 2030 requires a surge in commitment, resources, and political will.
This story is based on reporting from VaccinesWork and information provided by Gavi.
