Despite repeated warning from the WHO, the Institute of Public Health (IPH) is still producing the obsolete anti-rabies vaccine through the nerve tissue culture process by spending Tk 1 crore every year.
The World Health Organisation (WHO) recommended stopping production of nerve tissue vaccine in 2003, 2006 and again in 2009 and suggested to use cell culture vaccine. No country except Bangladesh, Myanmar and Pakistan produces this vaccine in the world.
"The cell culture vaccine is more effective and its reaction is comparatively low. So, the WHO suggested to use this vaccine," said Joint Secretary to Public Health and World Health Syed Umar Khyyam.
Using the nerve tissue vaccine also has some reactions like fever, vomiting, diarrhoea and allergy. Even there is no any standard to justify the efficacy of the vaccine in the country, say the experts at the IPH.
There is no recognised laboratory for diagnosis of rabies in the country. So, most of the people take the vaccine without knowing whether they need it or not.
"People get rabies only from the bite of infected dogs. But in most cases, they get panicked and take the vaccine," said Habibur Rahman, former deputy director of the IPH. "So, often the vaccine proves effective for them and that is why it still has huge demand among the poor."
Every day on an average 180 people come to take the vaccine as it cost only Tk 40.25. There are other anti-rabies vaccines imported by different pharmaceutical companies with brand names like Rabipur and Verorab. These cost between Tk 1,500 and 2,700, which the poor people cannot afford, said the IPH sources.
The IPH has been producing the nerve tissue vaccine since 1956. But every year on an average about 2,000 persons die of rabies in the country, according to the WHO. Fifty-six percent of these deaths are caused to children less than 15 years of age.The Infectious Diseases Hospital (IDH) record shows the number of clinically diagnosed rabies cases has increased in the last few years.
In 2001 some 147 people were clinically diagnosed with rabies, which increased to 167 in 2006 and 177 in 2008.
It needs to go for long 14 painful courses if one wants to take the nerve tissue vaccine.
But, the fact is still a huge number of poor people throng the IPH to take the vaccine every day.
"I don't know anything about its being obsolete. I have just heard from the local people that I can get the vaccine from the IPH at Mahakhali. So, I've come here from Tangail to take the vaccine," said Monir Hossain whose son was bitten by a dog six days ago.
When asked, Monir, a truck driver, said, "Perhaps it was a mad dog. Otherwise, it would have not bitten a man."
"Until providing a better option for the poor patients, we cannot stop producing the nerve tissue vaccine just now. Because, around 52,000 patients are treated with the vaccine every year," said Director of the IPH Nurul Islam Prodhan.
If the government takes steps to provide the latest tissue culture vaccine like Rabipur and Verorab at a subsidised cost, it will need a separate laboratory, importing of bulk tissue and trained manpower, he said.
"The government has decided to come out from the nerve tissue vaccine and not to investment further in this project. But, as the cost of the tissue culture vaccine is higher, it is taking some time," he said.
The government is thinking of establishing a standard laboratory for producing vaccines and already sought cooperation from the WHO, he added.