Exemplary operational research on an important public health problem

Rabies is a fatal disease once contracted, and a serious public health problem. Immunisation was unaffordable and inaccessible for most affected people in India. Omesh Bharti's operational research allows us to reduce the unit dose needed for life saving rabies immunoglobulin (RIG) for class 3 rabid animal bites thereby raising hopes that access to this drug will improve. This study also suggests how public health research should question established guidelines that are rooted in impractical biomedicine without considering sociopolitical realities. The randomised controlled trial as a standard of research methodology is not only impractical but unnecessary. We discuss some of the challenges such as stockout of life saving medicines like RIG and suggest possible solutions. There is still a need to determine the correct RIG dose and the best technique for administering, storage and timing of this important drug.