Vol , Issue 
                
                Date of Publication: May 09, 2019
            
                             DOI: https://doi.org/10.20529/IJME.2019.022
                            
                     
        
            
            
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         Case Studies  
                
        Using a modified rabies immunoglobulin protocol in a crisis of unavailability: Ethical and practical challenges
        
        
        
        
            Abstract:
             Rabies is a dreaded disease of zoonotic origin, responsible for an estimated 55,000 deaths annually, of which 20,000 deaths are in India. Some animal bite patients need rabies immunoglobulin (RIG) for post exposure prophylaxis, in addition to the vaccine against rabies. The major reason for the high death rate in India is the high cost of RIG. Until 2017, the WHO-recommended protocol required a large amount of RIG. I describe how a cost-saving protocol for RIG was implemented in Himachal Pradesh. The published results contributed to the modification of the WHO’s global recommendations on RIG use.
         
        
            Copyright and license 
            ©Indian Journal of Medical Ethics 2019: Open Access and Distributed under the Creative Commons license (  CC BY-NC-ND 4.0), which permits only non-commercial and non-modified sharing in any medium, provided the original author(s) and source are credited.