Widespread use of the non-steroidal anti-inflammatory drug (NSAID) diclofenac to treat livestock has resulted in dramatic declines in the populations of vultures across India. This has become an issue of considerable concern as vultures are a keystone species and their decline has a range of socio-economic, as well as cultural and biodiversity impacts. In this paper, we review these impacts and estimate in detail the economic cost of one of them: the human health impacts of the vulture decline. Livestock carcasses provide the main food supply for vultures, and are also eaten by dogs. Dogs are the main source of rabies in humans in India, and their populations have increased substantially in parallel with the vulture decline. The potential human health impact of rabies associated with the vulture decline is found to be significant. This, and a wide range of other impacts suggest that significant resources should be put into (1) testing of pharmaceutical products to ensure that similar situations are not repeated, (2) helping vulture populations to recover through the use of alternative drugs to diclofenac that are of low toxicity to vultures, and (3) through conservation breeding programmes.