Rabies is a fatal zoonotic disease, and India is its largest reservoir. Sixty percent of the world’s rabies cases are reported in India. Because the domestic canine population is 27 million, with the majority being stray and unvaccinated, rabies is a huge public health hazard, causing an estimated death every half hour.
Fortunately, death from rabies is preventable. Seven million people receive preventive treatment in the form of post-exposure prophylaxis after a dog bite each year, of which approximately 3.5 million reside in India. India’s annual mortality rate of 20,565 from rabies could be greatly reduced with increased public awareness and timely access to this intervention.
For decades, only a nerve tissue vaccine derived from sheep’s brain was available in India. Although the vaccine’s efficacy was proven in the scientific literature, its safety was not. The ethical implication of slaughtering hundreds of sheep was also of concern to many. Recognizing the need for a low cost replacement verocell vaccine, the government sought a company with the expertise and motivation to forego high profit margins to develop this social product for poor, high-risk populations. They turned to Indian Immunologicals (IIL).
IIL noted that in addition to the need for a modern tissue culture vaccine at affordable cost, there existed a need to make it accessible . In times of shortages in Government Hospitals, where animal bite treatment was available freeof costs, the patients had to go to retail pharmacies with government or private prescriptions where they cannot even afford the first dose. Sadly, they must pool their life savings and borrow money to buy the life-saving medicine.
The trade distribution channel, through retailers and shops, was also found to be ridden with inefficiencies. Over-priced multi-national brands and multiple consultation fees lead to poor follow-up adherence for the multi-dose treatment among patients of private practitioners. Further, along the long supply chain, cold chain maintenance is threatened and incremental costs accumulate, burdening the end user. Based on an accrual system, if products are not moved efficiently, company cash flow and liquidity suffer.
Further, In India’s informal health sector, quacks misguide patients to use concoctions instead of proper vaccines. A formidable challenge is educating the public about the potential fatality of a dog bite and the importance of taking the full course of post-exposure prophylaxis.
Analysis of the these issues led IIL to arrive at its Franchisee model of Abhay Clinics.