Rabies and Public Health: A Narrative Review on Epidemiology and Control Strategies in Pakistan

Background: Rabies remains a major public health concern in regions with large populations of free-roaming dogs and limited veterinary awareness, further complicated by sociocultural barriers to prevention and control. Despite global efforts, the disease continues to cause significant suffering and mortality, underscoring the need for a coordinated, multi-sectoral response. This review synthesizes current evidence on the epidemiology, prevention, and control of rabies in Pakistan, emphasizing the One Health framework, vaccination strategies, and sociocultural challenges, to identify key gaps and propose actionable recommendations toward rabies elimination by 2030. Methods: A comprehensive literature search was conducted using PubMed, Google Scholar, and CINAHL to identify studies on rabies published between 2015 and 2024. The review focused on rabies epidemiology, vaccination efforts, control strategies, and key challenges, and used a thematic synthesis approach to identify emerging trends, best practices, and policy recommendations for improving rabies control. Results: Results demonstrate the necessity of a One Health approach consisting of mass dog vaccination, management of stray dog populations, improved surveillance, and policy enforcement for rabies eradication. Awareness and education programs that engage the community are pivotal in increasing vaccine uptake and responsible pet ownership. It is also vital to improve and strengthen the laboratory diagnostic capacity to enable early case detection and response. Sabotaging factors such as vaccine shortages, poor surveillance systems, and inadequate implementation of policies are significantly hampering efforts to control rabies on a sustained basis. Conclusion: A sustainable rabies elimination strategy must be approached from a multidisciplinary perspective where vaccination coverage, community participation, training, and strong surveillance mechanisms take priority. Global eradication of rabies will only be achieved through strengthening health systems, enforcing animal welfare policies, and integrating public health actions. Future research should also explore the socio-behavioral factors affecting rabies control to improve intervention effectiveness.