How vaccination is powering Bhutan’s rabies control success 

The World Organisation for Animal Health (WOAH)’s inaugural publication of the State of the World’s Animal Health, brings to the forefront the role of vaccination in safeguarding animal health. This emphasis on vaccination is mirrored in Bhutan’s ambitious initiative to control rabies. In 2021, following a royal decree, the country launched its most ambitious animal health initiative: the Nationwide Dog Population Management and Rabies Control Programme, aimed to achieve mass anti-rabies vaccination as well as 100% sterilisation of free-roaming dogs.

By October of 2023, the country – whose sizeable dog population is more than 100,000 – had successfully sterilised all free-roaming dogs and achieved 90% rabies dog-vaccination coverage across the population. Now, nearly rabies free, the nation is working hard to sustain its achievement, placing control in the hands of the local governments and looking beyond its own borders to achieve rabies-free status by 2030.

Rabies in Bhutan 

At the time of writing, rabies is not present across the entire country, which is divided into 20 districts known as dzongkhags, but primarily the southern and eastern regions due to their proximity to the national border. However, this hasn’t always been the case. “Although official records are limited, research has documented that in the 1970s and 1980s rabies was prevalent in many parts of the country,” shares Dr. Rinzin Pem, Bhutan’s Chief Veterinary Officer. “In the 1980s, control efforts focused on mass culling of dogs. However, this approach was strongly opposed by the public, reflecting Bhutan’s cultural and spiritual reverence for life and widespread disapproval of animal killing.” 

In fact, public opposition was a significant factor that led the country to find alternate solutions. “Bhutan is a small country with close-knit communities, so public sentiment had a strong influence,” continues Dr. Pem, “The realisation that vaccination was an evidence-based alternative to culling ultimately led to the shift in strategy.”  

Bhutan’s nationwide action 

In addition to the public’s existing trust in the country’s government run Veterinary Services, Bhutan’s early vaccination campaigns were supported by extensive awareness and advocacy programmes, particularly in schools across high-risk dzongkhags, which promoted dog population management and fostered broad public acceptance of vaccination efforts. Well established animal health services gave vaccination initiatives a substantial network to work with. These factors paired with rabies vaccines being distributed free-of-charge by government workers resulted in strong support from the public and ongoing annual vaccination programmes.  

Building on the back of these annual campaigns, in 2021 by royal decree Bhutan launched the Nationwide Dog Population Management and Rabies Control Progamme. The largest coordinated vaccination and sterilisation effort the nation has undertaken to date. This effort was a whole-of-nation approach in which Bhutan’s Veterinary Service secured financial resources, engaged communities, and worked with 12,000 volunteers – locally known as Desuups.  

“Prior to this,” Dr. Pem explains, “Our vaccination efforts were more ad hoc and dependent on available resources. We always aimed for 70% coverage, but funding constraints often limited our reach.” The nationwide campaign completely changed this, ensuring a more systematic and effective approach. “If you visit Bhutan now,” she reflects, “You’ll notice that all free-roaming dogs in the streets have notched ears. This means they are sterilised and vaccinated.”  

Looking ahead 

Now, the challenge lies in sustaining the success of the initiative. “To maintain what we’ve accomplished,” says Dr. Pem, “We’ve handed over responsibility to local governments, who are now tasked with maintaining 100% sterilisation of free-roaming dogs and ensuring at least 70% vaccination coverage against rabies.” Beyond this, the initiative aims to sustain 100% vaccination for pet dogs, especially in high-risk areas, and regulatory changes have been made to keep vaccine compliance high, including leash and microchip requirements for pets. These legal measures set the country up to achieve rabies-free status by 2030.  

Even with the overwhelming success of the programme, there remain challenges to overcome. One of which is the transborder nature of the disease. Being a landlocked country, Bhutan faces occasional outbreaks due to cross-border incursions. In an effort to mitigate this issue, the nation piloted a cross-border vaccination program in collaboration with neighbouring countries in 2024. “We continue to push for sustained collaboration, but implementation takes time,” Dr. Pem explains, while remaining hopeful, “As a global community, we need to shift our perspective. We can’t think solely in terms of national borders; diseases don’t. Stronger regional collaboration is the only way forward.”