Breaking the Barriers to Access a Low Cost Intra-Dermal Rabies Vaccine Through Innovative “Pooling Strategy”英文文献资料.docVIP

World Journal of Vaccines, 2012, 2, 121-124 121 /10.4236/wjv.2012.23016 Published Online August 2012 (http://www.SciRP.org/journal/wjv) Breaking the Barriers to Access a Low Cost Intra-Dermal Rabies Vaccine through Innovative “Pooling Strategy”* Omesh Kumar Bharti , Wim Van Damme , Kristof Decoster , Petros Isaakidis , An Appelmans , 1 2 2 2 2 3 4 Vidya Ramachandran , Archana Phull 1 Government of Himachal Pradesh, Shimla, India; 2 Institute of Tropical Medicine, Antwerp, Belgium; National Institute of Epide- 3 miology, Chennai, India; 4 Bureau Chief Daily Post, Shimla, India. Email: bhartiomesh@ Received March 7 , 2012; revised April 10 , 2012; accepted May 12 , 2012 th th th ABSTRACT Background: In India every year an estimated 20,000 patients die of Rabies. Major reason for poor compliance to anti-rabies prophylaxis is the high cost of anti-rabies vaccine being prescribed intramuscularly (IM) as a routine i.e. 44.5 USD per course of five injections. In 1992 WHO recommended low cost intra-dermal rabies vaccination (IDRV), which costs only 7.5 USD or less per animal bite course. Methods: Interviews with doctors revealed that they were not prescribing intra-dermal anti-rabies vaccination as they were either not aware or were not confident of this route of ra- bies vaccination. Also the vaccine vial did not have the label for “intra-dermal use”. These barriers were removed by advocacy efforts with policy makers drug companies, credit sharing team building, which led to starting of first intra dermal anti-rabies clinic of North India on 2 August 2008. Results: Within a month o