Why Policy on Paper Isn’t Saving Lives on the Street
While “One Health” is India’s official roadmap, the Delhi crisis proved the engine is still stalling. Data silos, budget delays, and fragmented accountability show that having a plan on paper is meaningless if municipal, medical, and veterinary sectors don’t synchronize.
“One Health” is no longer just a buzzword in India. Since NAPRE’s launch in 2021, official policy documents, UNDP briefs and NRCP guidelines repeatedly describe rabies elimination as a test case for operationalising One Health – integrating human, animal and environmental health systems. But Delhi’s 2025 dog crisis exposed how fragile that integration remains.
Where coordination is genuinely improving
Several national‑ and state‑level developments indicate real, if uneven, One Health traction:
- NAPRE 2021 explicitly structures rabies elimination around joint responsibilities for the Ministry of Health, Department of Animal Husbandry & Dairying, municipal authorities and environment/urban‑development departments.
- Rabies‑Free Cities and Rabies‑Free India portals (NCDC) provide a shared platform for data, guidelines and tools that can be used by both medical and veterinary officials.
- State Action Taken Reports, such as Odisha’s 2025 NRCP report, describe joint planning of dog‑vaccination campaigns and human PEP services, mass dog vaccination targets (>70% coverage), rabies‑free city pilots, and integrated IEC campaigns aimed at communities and frontline workers across sectors.
- Medical‑education advisories, such as a 2025 National Medical Commission note, encourage inclusion of zoonoses and One Health concepts – with rabies as a core example – in MBBS training and CME, seeding future cohorts of clinicians with a more integrated lens.
These are not cosmetic moves; they mark a slow but real shift from siloed programmes to shared frameworks, at least on paper and in a handful of better‑resourced states.
The structural blind spots: data, budgets, accountability
Set against those gains are three persistent blind spots that Delhi’s crisis made impossible to ignore:
- Data fragmentation
- Human rabies deaths are still grossly under‑reported in official national surveillance (dozens of cases vs thousands estimated), while animal rabies surveillance is patchy and laboratory capacity uneven.
- Bite, vaccination and ABC data often sit in different systems with weak interoperability, making it hard to get a real‑time picture of risk and coverage.
- Budgetary silos
- Public‑health budgets fund vaccines and PEP, while municipal or animal‑husbandry budgets fund CNVR/ABC, often with irregular releases and delayed NGO payments (as seen in Delhi’s ₹13.5‑crore arrears).
- Few states have formal joint financing mechanisms for One Health rabies projects; cooperation depends heavily on personalities and ad‑hoc arrangements.
- Accountability gaps
- When a rabies death occurs, no single authority is clearly answerable: health departments may blame late presentation; municipal officials may cite lack of funds; animal‑husbandry officers may highlight court restraints or activist opposition.
- District‑level One Health committees exist on paper in some areas but often meet infrequently and lack hard performance metrics.
In the Stepwise Approach towards Rabies Elimination (SARE) scoring, India was at about 1.5/5 in 2019, indicating early planning but far from the final stages of demonstrable elimination. Goa’s SARE score of 2.5 around the same period – with elimination already achieved – shows how state‑level performance can outpace national average when governance aligns.
What the Delhi episode revealed
The Delhi stray‑dog saga underlined that even in the capital, intersectoral coordination is reactive, not proactive:
- The Supreme Court intervened only after a child’s rabies death and rising public anger, rather than as part of a planned One Health roadmap.
- Civic bodies, health departments and animal‑welfare agencies were summoned into the same courtroom because they had not managed to self‑coordinate effectively outside it.
- Legal orders oscillated between mass confinement and ABC‑aligned CNVR not because the science changed, but because different Benches weighed law, safety and welfare differently in the absence of a shared, operational One Health consensus.
The Delhi case is best seen as a stress test: it revealed that India’s One Health architecture has matured enough to have frameworks and pilots, but not enough to prevent high‑profile crises or ensure consistently evidence‑based, feasible responses under pressure.
–Singdha Pradhan
