How Did Bhutan Stop Dog-Transmitted Rabies? The One Health Strategy Behind a Historic WHO Milestone

Bhutan has become the first country in the WHO South-East Asia Region to eliminate dog-transmitted human rabies as a public health problem, the World Health Organization (WHO) said on September 4, 2026.

The country has reported no human deaths from dog-mediated rabies since June 2023. A WHO-supported assessment conducted from August 17 to 22, 2026, confirmed that Bhutan had met the required criteria for elimination.

The achievement is significant because rabies is almost always fatal once clinical symptoms appear, yet deaths can be prevented if infected dogs are controlled and people who are bitten receive treatment quickly. Bhutan’s experience shows how vaccination of dogs, access to post-exposure treatment, surveillance, and community involvement can work together to stop human deaths.

The strategy started with the dogs

Rather than focusing only on treating people after bites occurred, Bhutan put major emphasis on controlling rabies at its source.

For more than a decade, the country has followed a One Health approach, bringing human health officials, veterinarians, local authorities and communities into the same effort. When a suspected rabies case is reported, animal and human health teams work together to investigate possible exposure and determine whether further action is needed.

Dog vaccination and population management became central parts of the program. Community awareness efforts were also expanded, with the national De-suung volunteer service, known as the “Guardians of Peace,” helping take these measures across the country.

“Bhutan has shown that eliminating dog-mediated human rabies is possible when strong national leadership, a mature One Health approach and communities come together around a shared goal,” said Dr Nilesh Buddha, Officer-in-Charge of the WHO South-East Asia Region.

What happens if someone is bitten?

Stopping rabies transmission does not mean every possible exposure disappears. People can still encounter potentially infected animals, which is why Bhutan has maintained access to post-exposure prophylaxis (PEP).

PEP can prevent the virus from reaching the brain and spinal cord after a potentially dangerous bite or scratch. It includes thorough washing of the wound, a course of human rabies vaccines and, when required, rabies immunoglobulin.

Bhutan plans to keep PEP free and universally available across all 20 districts, while continuing mass dog vaccination, dog population management and combined human-animal surveillance.

WHO Director-General Dr Tedros Adhanom Ghebreyesus congratulated Bhutan and linked the achievement to cooperation across sectors.

“Bhutan’s success shows that the health of humans, animals and the environment we share is inextricably linked,” Tedros said. He added that the fight against rabies is won “not in silos, but through solidarity across all sectors.”

How WHO confirmed Bhutan’s achievement

WHO did not simply declare Bhutan rabies-free based on the absence of recent deaths. The country had to provide technical evidence showing that transmission had been interrupted and that it had the systems needed to prevent the disease from returning.

A regional Dossier Review Group, convened by WHO with support from the World Organization for Animal Health (WOAH), carried out a two-stage assessment.

First, experts reviewed Bhutan’s submitted evidence. They then conducted a field mission from August 17 to 22, 2026, visiting health facilities, laboratories and program sites, reviewing records and information systems, examining the Bhutan-India border area and speaking with health officials and other stakeholders.

Under WHO’s criteria established in 2018, countries seeking validation must demonstrate at least two years without human deaths from dog-mediated rabies, along with strong surveillance, laboratory diagnosis, animal vaccination, timely PEP and the ability to respond if transmission is reintroduced.

Bhutan still has to protect the gains

WHO’s validation does not mean Bhutan can stop its rabies programs.

The country plans to continue vaccination and dog population management while strengthening surveillance. It also intends to improve coordination with neighboring Indian states because animals and diseases do not follow national borders.

“WHO has been privileged to walk alongside the Ministry of Health and the people of Bhutan on this journey, and remains committed to supporting the country in sustaining and strengthening the systems that have delivered this achievement,” said Dr Bhupinder Kaur Aulakh, WHO Representative to Bhutan.

The milestone also feeds into the wider global “Zero by 30” goal, a joint strategy involving WHO, WOAH and the Food and Agriculture Organization of the United Nations, with partners including the Global Alliance for Rabies Control. The target is to end human deaths from dog-mediated rabies by 2030.

Globally, dogs account for up to 99% of human rabies transmissions, according to WHO. Bhutan’s progress therefore offers a practical example of what can happen when disease prevention starts with the animal source while keeping rapid treatment available for people who are exposed.