Himachal doctor’s prophylaxis to prevent Rabies which reduced treatment cost from Rs 35,000 to Rs 350 gets WHO nod

In a moment of pride for Himachal based doctor Omesh Bharti, the World Health Organisation (WHO) has approved a Rabies immunisation protocol which was developed by him.

As per an India Today report, the treatment developed by the 49 year old doctor, who works in a government hospital, has been designated as a new global standard by the global health body. The treatment apart from being effective, substantially reduces the treatment cost from Rs 35,000 to a mere Rs 350.

As per the earlier treatment, the patients were injected with the rabies immunoglobulin (RIG) and rabies vaccine which are extracted from horse or human blood. The Human RIG incidentally had to be administered in large quantities based on the patient’s body weight, which resulted in a cost of Rs 6000 – Rs 8000 per vial.

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So Dr. Bharti, while being a health officer with the Shimla Municipal Corporation from 2013-15, developed a protocol to administer a small fraction of that RIG which did the trick. The quantity of the vaccine required to be injected came down by 90% when it was injected in the dermis (a layer of skin below the epidermis) as opposed to in the muscle.

This treatment procedure by Dr. Bharti was wholeheartedly supported by the Himachal health authorities, which also included training medical professionals to administer it.

By 2016, Dr. Bharti’s treatment had yielded over 7000 successful cases in Himachal and WHO’s Strategic Advisory Group of Experts (SAGE) too had included his protocol for discussion in its Bangkok meet. The treatment by Dr. Bharti was finally endorsed by SAGE on 15th January as a cost, dose and time-sparing treatment, along with being safe and clinically effective.

As pointed out on Twitter by scientist Anand Ranganathan, the effectiveness of Dr. Bharti’s procedure can be gauged by the fact that in 2017, there were just two rabies related deaths in Himachal (which follows Dr. Bharti’s procedure), as opposed to a whopping 20,000 in India:

These two deaths could also have been avoided as one of the deceased refused treatment and another chose to visit a private practitioner.

And just to point out, this treatment is administered in Himachal free of cost.

Incidentally this isn’t the only medical achievement Dr. Bharti has notched under his belt.

In April, 2017 it was reported that Dr. Bharti had published a paper titled, “Transporting snake bite victims to appropriate health facility within golden hour through toll free emergency”.

This paper which also impressed WHO, proposed administering of anti-snake venom (ASV) in ambulances itself, while transporting the victim to a hospital. This measure which involved ambulances carrying the ASV, was implemented in Himachal Pradesh, and was soon adopted by other states and union territories. This elegant solution saw the survival of 95% of the patients transported in these emergency ambulances, which was followed up by a two day hospitalisation.

Update: An earlier version of the headline incorrectly mentioned that Dr. Bharti had devised a new cure for Rabies. What Dr. Bharti has come up with is a new prophylaxis to prevent rabies after being bitten by an infected animal. There is no known proper cure for rabies which necessitates the preventive measures. 

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