The Expert Committee acknowledged the public health need for effective interventions for rabies postexposure prophylaxis, noting that the case fatality of rabies infection is almost 100% after the onset of clinical symptoms and that access to rabies postexposure prophylaxis is still inadequate in many settings where rabies is endemic.
The Expert Committee noted that efficacy of eRIG is similar to hRIG and that adverse events are minimal with available purified eRIG preparations. The Expert Committee also noted that eRIG is recommended in WHO’s 2018 rabies vaccine position paper approved by the Strategic Group of Experts on Immunization and that the price of eRIG is considerably lower than for hRIG.
Therefore, the Expert Committee recommended that purified eRIG be included on the core list of the EML and EMLc for use as part of rabies postexposure prophylaxis, in line with WHO recommendations and based on a favourable benefit-to-harm ratio. The Committee considered that eRIG will provide a valuable alternative option to hRIG, at a lower cost, and increase procurement options.