One vision, one health, zero rabies

Rabies is a fatal but preventable viral infection of the central nervous system, responsible for thousands of human deaths each year, mostly from dog-mediated transmission. Children are disproportionately affected, and once symptoms appear, the disease is almost invariably fatal. Rabies virus (RABV) and related Lyssaviruses circulate among dogs, bats, and wildlife, with growing genetic diversity raising long-term concerns for current vaccines. Clinical diagnosis is difficult during incubation, and postmortem confirmation remains the standard, underscoring the critical importance of prevention. Effective management centres on immediate wound cleansing, timely administration of rabies vaccines, and rabies immunoglobulin when indicated. At the population level, rabies elimination hinges on the One Health approach, linking human, animal, and environmental health. Mass dog vaccination reaching at least 70% coverage, integrated bite case management, and prompt post-exposure prophylaxis are proven strategies. Case studies from Goa and Tamil Nadu, India, demonstrate the feasibility of coordinated programs that combine vaccination, surveillance, digital tools, and community education to drive human rabies deaths to zero at cost-effective levels. Despite setbacks during the COVID-19 pandemic, global efforts such as the Zero by 30 initiative emphasize that rabies elimination is a realistic goal. Protecting animals, protecting people, and sustaining communities through One Health action offers a clear path to ending human rabies deaths worldwide.