● A modelling study demonstrates that expanding access to Post-Exposure Prophylaxis (PEP) for those who need it most could save thousands of lives annually
● WHO-recommended vaccination method could cut vaccine use by over 50%—even in rural areas
A new study published in the Journal Vaccine reveals that improvements in the supply chain and delivery of human rabies vaccines in Tanzania and Kenya could significantly reduce preventable deaths and ensure more efficient use of health budgets.
The study was conducted by researchers from the University of Glasgow, Ifakara Health Institute, the Centre for Epidemiological Modelling and Analysis (CEMA) at the University of Nairobi, the University of Edinburgh, and Washington State University, with support from the Wellcome Trust. It demonstrates that adopting the World Health Organization (WHO) -recommended intradermal (ID) vaccination method—which enables a single vial to treat multiple patients—can reduce overall vaccine use by more than 55%. This approach also significantly lowers the risk of stockouts, even in rural areas where patient visits are less frequent.
Rabies is one of the world’s deadliest diseases—particularly in low- and middle-income countries—causing around 59,000 deaths annually, despite the availability of effective post-exposure prophylaxis (PEP). Many of these deaths occur because people cannot access timely treatment with the PEP vaccines. Frequent stockouts, high costs, and long travel distances to clinics present serious barriers to care.
This modelling study evaluates vaccine demand, supply chain challenges, and management strategies using real-world data from Kenya and Tanzania. It examines how rabies vaccine supply chains can be strengthened to ensure people exposed to the rabies virus receive timely, life-saving protection.
The researchers found that by adopting WHO recommendations of intradermal use in clinics with multiple bite patients daily, improving restocking strategies, and decentralizing PEP services, countries can strengthen their readiness to deliver PEP more efficiently and effectively.
“It is unacceptable that people are still dying from rabies when effective vaccines are available,” said Martha Luka, lead author of the study and a postgraduate researcher at the University of Glasgow. “By improving stock management and adopting dose-sparing intradermal vaccination, countries can protect more people with fewer resources.”
The study also analyzed how vaccines are currently distributed and restocked across various health facilities. In Tanzania, where PEP is usually available only at central hospitals, decentralizing access to more local clinics can improve equity and access—especially for those in remote areas.
To avoid shortages, restocking strategies must be tailored to the average number of patients seen at each facility. The researchers developed simple, setting-specific rules for determining how much stock is needed and when to reorder—supporting health systems to respond swiftly to sudden surges in demand.
“We have provided a practical and evidence-based roadmap to improve how rabies vaccines are delivered in Tanzania, said Kennedy Lushasi, a co-author of the study and a researcher at the Ifakara Health Institute. “By integrating vaccines into routine supply chains and expanding access to local clinics, we can save lives, reduce costs, and protect the most vulnerable. We call upon policymakers and public health leaders to act now. Every life lost to rabies is a tragedy– one we now have the tools to prevent. Let’s make those tools available to everyone, everywhere,” he added.
These strategies come at a pivotal moment as Gavi, the Vaccine Alliance begins investing in expanded access to human rabies vaccines, supporting efforts to achieve zero human deaths from dog-mediated rabies by 2030. Gavi’s approach includes integrating rabies vaccines into national immunization supply chains across Africa, Asia, and other Gavi-supported countries. This must be coupled with vaccinations of dogs, which are the main sources of rabies in humans.
“Gavi’s investment is a transformative milestone for public health in Africa and Asia,” said Mumbua Mutunga, co-author and PhD Fellow at the Center for Epidemiological Modelling and Analysis (CEMA), University of Nairobi. “Our research shows that with the right supply chain strategies and adoption of dose-saving intradermal injections, countries can move beyond reactive responses to sustained, reliable protection – helping to prevent the heartbreaking and unnecessary loss of life, especially among children in underserved communities.”
“Strategic investment and data-driven planning as demonstrated in our publication are not just good to have – they are critical in making emergency vaccines accessible, dependable, and timely,” Mutunga added. “This is how we reach the communities that have been left out for far too long, preventing avoidable rabies deaths.”
“With the right strategies in place, achieving Zero by 30 is entirely possible,” Luka concluded. “Now is the time for countries to leverage Gavi’s investment to build strong, resilient systems that guarantee timely access to PEP for everyone at risk.”
