Zero by 30: a critical appraisal of India's national action plan for dog-mediated rabies elimination- progress, bottlenecks and priorities for 2026–2030

India carries the largest national share of the global burden of dog-mediated rabies. Through the National Action Plan for Dog Mediated Rabies Elimination (NAPRE), launched on World Rabies Day 2021, it has committed to zero human deaths from dog-mediated rabies by 2030 under a One Health framework. With just over four years remaining, this review appraises published evidence and official data in four domains: the burden baseline, dog vaccination, surveillance and post-exposure prophylaxis (PEP). National estimates of annual deaths range from about 20,000 (a 2003 survey and 2015 global modelling) to 5,726 (a 2022–23 community survey), whereas routine surveillance recorded only 21–54 deaths a year in 2022–2024, so mortality cannot serve as a short-term indicator. Goa shows that elimination is achievable in India: vaccinating more than 95,000 dogs a year at 70% coverage ended human deaths by 2018. Nationally, however, dog vaccination is mandated through municipal Animal Birth Control programmes whose effectiveness has not been formally assessed, and animal rabies, although a scheduled disease with obligatory reporting under the Prevention and Control of Infectious and Contagious Diseases in Animals Act, 2009, remains largely unreported. Gaps in PEP are substantial: more than one in five dog-bite victims received no vaccine, pooled schedule compliance is about 57%, and rabies immunoglobulin was available in only one-fifth of public facilities. We propose five measurable priorities for 2026–2030: verified vaccination coverage, enforced animal-rabies reporting, integrated bite case management, district-level diagnosis, and spatially directed vaccination backed by an uninterrupted supply of biologicals.