One health approach to rabies in India: bridging veterinary and medical systems to achieve zero by 2030

India carries close to a third of the global dog-mediated rabies burden [4,5] and has committed, through the National Action Plan for Dog-Mediated Rabies Elimination (NAPRE, 2021), to zero human deaths by 2030 [2,6]. This review asks why a country with a national plan, notifiable-disease status, domestic vaccine manufacturing and two documented state-level elimination successes still loses thousands of lives each year, and identifies the specific veterinary-medical interfaces that must be engineered before 2030. We synthesise the 2022-23 ICMR-NIE nationwide community survey [4,9], National Rabies Control Programme returns [6,8], WHO/WOAH/FAO guidance [1,2], national genomic surveillance [27,28], and elimination programmes from Goa [15], Sikkim [16], Bohol [17] and Latin America [18,19]. Modelled Indian mortality of 5,726 deaths annually exceeds the 54 suspected deaths notified in 2024 by roughly a hundredfold [4,8]. The binding constraint is architectural, not therapeutic. Four joints are broken: bite reports that never reach the veterinary sector, mass dog vaccination without a credible population denominator, post-mortem animal diagnosis concentrated in too few laboratories, and Integrated Bite Case Management (IBCM), which remains absent from NAPRE [6,20]. Whole-genome data showing predominant Arctic-like 1a circulation with state-level clustering indicate that transmission is largely local, that antigenic sites are conserved, and that district-scale elimination with traceable reintroduction is realistic [27,28]. Rabies elimination in India has become an integration problem rather than a scientific one. Seven measurable actions, each with a named owner and a 2030 indicator, would convert an adequate plan into a verifiable outcome [2,6].