"The last vaccine has just been given." 

The short message reached the phone of a West Nusa Tenggara (NTB) Provincial Health Office officer on the night of 16 September 2026. It came from a health worker at the Alas Community Health Centre, Alas Subdistrict, Sumbawa District. The vaccine was given to a two-year-old girl who was bitten by a dog on the neck and face.  The centre needed to replenish its stock of rabies vaccine and serum, both to complete her treatment and to ensure supplies were ready for the next patient who might arrive with a similar exposure. The location of the bite made every hour critical: rabies travels through the nerves towards the brain, and bites to the head and neck can have shorter incubation periods because they are closer to the central nervous system. 

Rabies is preventable. However, once symptoms appear, the disease is almost invariably fatal. 

With rabies, early action can mean the difference between life and death. Timely administration of Anti-Rabies Vaccine (VAR) and Anti-Rabies Serum (SAR) after exposure can prevent rabies before symptoms appear.  But that protection depends on having the right supplies in the right place, at the right time. Without enough stock, a bite that could have been treated can quickly become a life-threatening emergency. 

But stopping rabies is not only about what happens after a bite. It starts with keeping dogs vaccinated, tracking animal and human cases, ensuring health facilities have enough supplies, and knowing where risks are emerging. In the past, these efforts were often managed separately, with different teams and systems working on different parts of the problem. Health centres track people who have been bitten, animal health teams monitor dog vaccination, and logistics teams keep an eye on vaccine and serum supplies. A rise in dog bites in one subdistrict, for example, may coincide with low serum stocks in another, but without a shared picture, the warning signs can easily be missed. 

The One Health approach brings these pieces together. It connects human health, animal health and the environment, allowing information to be shared, risks to be spotted earlier and teams to act together. By connecting these efforts and the information behind them, teams can spot risks earlier and respond before more people are exposed. 

"In the human health sector, the Program Performance Indicator (IKP) is declared achieved when a district/city has no cases of human deaths from rabies or no rabies-positive specimens are found in animals in the past two years," said dr. Fadjar M. Silalahi, Head of the Working Team on Vector-Borne and Zoonotic Diseases, Venomous Animal Bites, and Poisonous Plants, Ministry of Health of the Republic of Indonesia. 

The stakes are high. Of Indonesia’s 38 provinces, 26 remain rabies-endemic. Rabies claimed 122 lives in 2024, 156 in 2025, and 71 as of August 2026 [source: Ministry of Health]. These numbers are a reminder that every bite can become a race against time. In Alas, that race was unfolding for a two-year-old girl bitten on the face and neck. Her safety depended not only on receiving treatment quickly, but on whether the next dose would be available when she needed it. In rabies-endemic areas, the risk remains as long as infected animals continue to pose a threat and vaccination coverage among healthy animals remains incomplete. 

From Midnight to Mandalika 

That night on 16 September 2026,  the connection between data and action made all the difference.  Instead of calling health facilities one by one, officers at the NTB Provincial Health Office opened SMILE (Electronic Health Logistics Inventory Monitoring System), an application developed by the Ministry of Health together with the United Nations Development Programme (UNDP), with support from Gavi, the Global Fund, and the Government of Japan. On one dashboard, they could see the remaining stocks of Anti-Rabies Vaccine (VAR) and Anti-Rabies Serum (SAR) from the provincial level down to districts and cities. 

The NTB Provincial Health Office contacted its counterpart in Bali and, together with the Ministry of Health, arranged for hundreds of vials to be sent to NTB as a buffer. In that moment, SMILE showed how a homegrown digital innovation can turn data into action, connecting two provinces and helping move a lifesaving treatment closer to a child who needed it. 

But the bigger opportunity is what happens when this kind of connected information is used across the health system. Rabies does not stop at the boundaries between human and animal health, so neither should the response. Under Indonesia’s One Health system, information on human cases, animal health and available supplies can be brought together to identify risks earlier and guide action where it is needed most. 

That matters not only for patients, but also for places that depend on people feeling safe. Ahead of the MotoGP at Mandalika Circuit in Central Lombok, one of Indonesia’s major international tourism destinations, the NTB Provincial Health Office and Central Lombok District Health Office worked with animal health teams to manage stray dog risks around the circuit and ensured health facilities had enough VAR to cover a full month. The preparation meant that rabies risks were being managed alongside the wider health planning for an event expected to draw visitors, helping communities and tourists enjoy Mandalika with greater confidence. 

The story that began with a late-night message in Sumbawa points to a bigger lesson. Whether it is getting serum to a child who has been bitten or preparing a major tourism destination for thousands of visitors, rabies prevention depends on the same things: information that moves, teams that work together and action taken early. SMILE helps make that possible, under One Health system that connects the people, animals and places at the centre of the response. 

For the little girl in Alas, the system worked. The serum arrived in time, and she is now in good health. The real measure of progress, however, is not only how quickly the system responds when an emergency happens, but how often it helps prevent one from becoming a crisis. 

Authors: Ahmad Mujamil, Noor Hasibuan

Editors: Vidia Darmawi, Nabilla Rahmani