Public-Private Partnership (PPP) in humane dog population control

– utopia or possibly the essential next step towards a sustainable solution?

BY ILONA OTTER | April 29, 2025

The journey of my thoughts over the last year

One year ago, around World Veterinary Day, I wrote my first post for this blog , noting that while writing or reading blogs was not anymore the popular thing to do, for my old-fashioned brain, it provided a way to structure and express my thoughts. Writing also helps them to develop. I have spent a lot of time this year reading, writing, and processing ideas around veterinary care accessibility, barriers to veterinary care, and the spectrum of care, especially the need to be able to set up spay/neuter surgery clinics for owned dogs in existing basic facilities. All this focuses on how to best move forward with the task of humane dog (and cat) population management in India. My original inspiration or spark for this journey was the ICAW conference in Bulgaria in 2022, where I first began to think how we are missing a major piece in the ABC program field if we don’t recognize the need for owned dogs to get operated and the role of private sector vets can play in it.

I began to think about how to encourage existing private veterinary clinics to arrange high-volume, high-quality spay/neuter campaign days for owned dogs at a low cost.

Earlier I had also realized that many vets were lacking the essential surgical instruments and equipment to do spay/neuter surgery, and therefore, with the access of vet care – online instrument store, I have tried to bring one possible solution for that problem and wrote how investing a bit to your own veterinary equipment, you are also investing to your own veterinary professional identity.

However, I knew this was still not enough, and I kept on thinking about it.

There was also the matter that many young vets are not finding job opportunities in India interesting enough and are choosing to move abroad. There was also the matter that many young vets who get trained in spay/neuter surgery to be able to work in stray dog ABC centers run by either municipalities or NGOs, do not stay very long in these jobs because there is often a lack of career development opportunities. They are also often recruited from other districts or states, and that means that eventually, they will move back to their home states or districts to get married or to get another job closer to their family and roots. This means the ABC programs are in constant need of recruiting and training new vets to be able to function continuously.

At the same time, there are small private clinics owned by vets who have made the investment to be established in that area for many years to come. These are the clinics that could be involved in improving access to affordable spay/neuter via a structured public-private partnership (PPP) program. Also, in many small towns where there are yet no private clinics, establishing one might become financially more viable when supported by a PPP program.

I voiced this idea of a PPP program in humane dog population management for the very first time at the general annual meeting of the Nilgiris SPCA in 2024 and have been ruminating on the idea further to finally draft the first concept note.

Role of PPPs in animal disease control

World Organisation for Animal Health (WOAH) recommends wider use of public-private partnerships (PPP) in the veterinary domain to help improve access to veterinary services that would otherwise be impossible to provide by either sector working in isolation. PPP is a joint approach where the sectors agree on responsibilities and how to share resources and risks to achieve the defined common objectives.

WOAH website has a lot of resources and case examples to show how and where PPPS have been successful. For example, PPPs have been used successfully in disease control interventions to increase vaccination coverage beyond what the public or private sector could attain alone.

Humane dog population management via surgical sterilisation of dogs is a supportive tool for rabies control. The main tool for rabies control is the annual vaccination of dogs. This should start by ensuring that all owned dogs are vaccinated annually, and moving on to mass vaccination programs that target ownerless roaming dogs. Rabies transmission is more likely in dog populations that include a large portion of roaming, unvaccinated dogs.

The idea of a PPP in humane dog population management would be to release the public sector from the need to secure land for an ABC center or to make capital investments into buildings, equipment, and vehicles, while same time helping to boost the ability of the private sector to provide services that come under the public sector domain. The humane dog population control in India is very much in the interest of the government. It is included as a supportive tool in the animal health component of the National Action Plan for Rabies Eradication (NAPRE), to reach the WHO’s set global goal of zero dog-mediated human rabies deaths by 2030. Rabies control is about zoonotic disease control and, therefore, a public sector responsibility.

Without effective spay/neuter surgery services available for all dogs, specifically for those who belong to people in the lower income groups, and to whom regular private veterinary clinic fees may be much too high to pay, the roaming and unvaccinated dog population continues to remain high. New unwanted puppies are continuously born to those pet dogs that were not surgically sterilized in time, and as these puppies are abandoned on the streets, they add to the free-roaming & unvaccinated dog population and therefore contribute to the maintenance of the high risk of rabies transmission within the population.

It is high time to start thinking outside of the traditional, ownerless, stray dog-focused box and to acknowledge that stray dogs do not exist in a vacuum. They are the result of unwanted owned dog pregnancies, which is the direct consequence of a lack of access to affordable spay/neuter surgery for many dog owners.

By focusing on providing better access to affordable spay/neuter for owned dogs, we are controlling the very source of stray dogs.

How Could It Work?

In summary, the action plan could be structured as follows:

The municipality will establish an official dog registration system that records the owners’ demographic and income data. Many cities already have similar systems in place, providing a solid foundation to build upon.
Owners who fall within the lower-income bracket, as determined by the municipality based on household monthly income, will receive a voucher for a free or low-cost spay/neuter surgery for their registered pet dog.
Along with the voucher, the owner will receive information about local veterinarians (in any employment sector) who have agreed to participate in this public-private partnership (PPP). These vets will perform the voucher-paid surgeries at scheduled dates and times that they will communicate to the owners.
The municipality and participating veterinarians will agree on a reimbursement amount for the spay/neuter surgeries conducted on eligible dogs. For instance, this amount could be set at Rs 2000 -Rs 2500 per dog. The amount is to be checked and confirmed annually.
Veterinary clinics will be responsible for providing all the necessary equipment, medication, and materials for the surgeries. They will also inform the public about available dates for voucher surgeries, which could occur weekly, monthly, or during designated long weekends, depending on the clinic’s preferences. Scheduling multiple voucher surgeries in one day helps make the lower-cost rate financially viable for the veterinary clinics. For more information on high-volume, high-quality spay/neuter programs, please refer to my earlier blog post.
The municipality will reimburse veterinarians at least once a month based on the number of surgeries performed using the vouchers. Veterinarians can opt out of this PPP at any time if they do not receive timely reimbursement or if they feel the system is no longer beneficial for their clinic.
Each vet clinic is responsible for ensuring that its registered and qualified veterinarians are adequately trained to perform surgeries. However, since the quality of this program hinges on the reputation of the private veterinarians involved, there is no need for external oversight or inspections by non-veterinary committees or authorities. Dog owners will sign a consent form indicating their agreement for their pet to undergo surgery at the chosen veterinary clinic.

Benefits of the Concept for Private Veterinary Clinics:

Positive Publicity: Clinics can gain positive visibility within the community.
Surgical Preparedness: Regular, guaranteed surgical cases allow clinics to invest in enhancing their surgical readiness.
1. Employment Opportunities: Clinics may consider hiring an assistant or a part-time junior veterinarian.
2. Improved Resources: Better selection of suture materials and surgical instruments can be made.
3. Enhanced Anesthetic Options: Clinics can offer a broader range of anesthetic choices.
4. Skill Development: Increased exposure to specific surgical procedures can lead to improved surgery and anesthesia skills for both veterinarians and assistants.
Improved Veterinary Services: Enhanced surgical preparedness enables clinics to handle other surgical and anesthesia-requiring cases more effectively, leading to a general improvement in veterinary services in the area. This development can also create more employment opportunities for young veterinarians.

Benefits of the Public-Private Partnership (PPP) for the Public Sector (Municipality):

Roaming Dog Population Control: The municipality can control breeding of the roaming dog population without needing to make more investments in vehicles, kennels, equipment, or surgical facilities. If such facilities are already provided and are in continuous use to operate stray dogs, this program should go on alongside the new owned-dog surgery provision via the PPP
Long-Term Strengthening of Veterinary Services: Funds allocated for surgeries can indirectly help bolster the local veterinary service providers over time. This, in turn, will create more opportunities for pet owners who do not qualify for vouchers to access surgical services at standard private clinic fees. This will also support the control of the dog population, improving the effectiveness of rabies control efforts.
Ease of Staffing: There will be less need for constant recruitment and training of new veterinarians to work in Animal Birth Control (ABC) centers.

Necessary Mindshift:

A fundamental change in mindset and policy is crucial. The government needs to permit the use of some of the ABC-program-earmarked funds to be used to subsidize the cost of spaying/neutering pet dogs owned by financially vulnerable individuals who cannot afford standard private clinic fees. Historically, in India, these individuals have had limited options for sterilizing their dogs on time to prevent unwanted litters.

However, this does not imply that existing stray dog ABC centers should be discontinued or replaced by this PPP. Instead, the PPP program should serve as an additional resource to support and complement the ongoing efforts to control the roaming dog population and reduce rabies transmission.

Is This a Utopia or Could It Work?

I look forward to hearing your comments and thoughts!