Rabies remains a near‑entirely preventable yet virtually 100 % fatal viral disease. Despite effective vaccines and post‑exposure treatments, recent data show a troubling uptick in rabies-related deaths worldwide. The World Health Organization (WHO) estimates around 59,000 human rabies deaths annually, a figure echoed by multiple studies. However, modeling research suggests true annual fatalities could be as high as 74,000, given under-reporting and weak surveillance. Underlying this increase are surging outbreaks and improved data capture in many regions.

Regionally, Asia and Africa bear the brunt—accounting for over 95% of deaths . In Asia alone, about 35,000 deaths occur each year, and Africa sees around 21,000, primarily from dog-transmitted rabies. In Southeast Asia, half of global rabies deaths (≈ 26,000 annually) originate, with countries like Cambodia, Bangladesh, Myanmar, Nepal, and Indonesia heavily affected. Some countries are witnessing surges. In the Western Pacific, 8,740 human cases were reported between 2013 and 2023, with 284 cases in the Philippines alone in 2022—a sharp rise from 213 cases in 2012. Malaysia’s Sarawak region has also reported deaths in recent years.

Meanwhile, Haiti continues to see two deaths per week post-2010 earthquake, underscoring persistent gaps in prevention. In contrast, high-income regions showcase the stark disparity. The United States reports only 1–3 human rabies deaths per year, mostly linked to bat exposures or travel to endemic countries. Western Europe, North America, Japan, Australia, and parts of Latin America have largely eliminated canine rabies through pet vaccination and wildlife control. Children under 15 remain disproportionately affected, accounting for approximately 40% of global rabies fatalities . The animal origin is overwhelmingly dogs—up to 99% of cases globally.

What’s driving the increase? Factors include inadequate mass dog vaccination, uneven post‑exposure prophylaxis (PEP) access, and weak surveillance systems. Improved detection and reporting also contribute to the apparent rise. Efforts are underway: WHO’s “Zero by 30” initiative promotes a One‑Health approach, encompassing mass dog vaccination, accessible PEP, surveillance, community education, and veterinary-public health collaboration. Successful examples include pilot programs in the Philippines that combine mass dog vaccination with community outreach, and Western Pacific improvements in diagnostics and surveillance.

However, unless global efforts intensify—especially in Africa and Asia—the 2030 elimination target is at serious risk. Key actions must include: Scaling mass dog vaccination to 70% or higher in high-risk areas. Ensuring timely, affordable PEP for bite victims. Strengthening surveillance systems and reporting. Educating communities, especially caregivers of children. Without these measures, rabies will continue to claim tens of thousands of preventable lives each year.