- by Alison Booth

Asia Charter calls for collaborative, integrated action on dengue

by Gary Finnegan

image of dengue mosquito, Aedes aegypti

Aedes aegypti is a mosquito that spreads, dengue fever, Chikungunya, Zika, yellow fever and other diseases.

Experts say it’s time to act and prevent dengue outbreaks

A coalition of dengue fever experts issued a powerful call-to-action in a bid to inject new momentum into the urgent battle against the disease.

The unprecedented move follows the inaugural Asia Dengue Summit which took place in January. The event attracted scientists and health professionals from 22 countries, putting a strong emphasis on the need for an integrated approach to the serious dengue fever outbreaks affecting the region.

Now, the four major global health organisations that put together the Summit have released a new ‘Charter’ urging authorities to prioritise dengue and coordinate their efforts. The statement is endorsed by the Asian Dengue Vaccination Advocacy (ADVA), SEAMEO Troped Network (SEAMEO), the Dengue Vaccine Initiative and Fondation Merieux.

The charter is designed to address the enormous challenges Asian nations are facing in contributing to the WHO goal of reducing dengue mortality by 50% and morbidity by 25% by the year 2020.

Asia has the highest dengue burden in the world with an estimated 70% of the global population at risk. Governments in the worst-hit countries spend nearly US $6.5 billion annually in both direct medical and indirect costs due to dengue.

The coalition says the growing threat warrants urgent and immediate action that can contain the rapid spread of dengue in Asia where nearly 67 million people contract the disease each year.

Professor Usa Thisyakorn, Professor of Pediatrics at Chulalongkorn University and Chairman of ADVA, described the January summit as “an historic event” that illustrated the commitment of health leaders and experts to unite against dengue. The Charter will build on its success.

“The success of the Summit signals a new awareness on the urgency for disease control and prevention,” she said. “The Charter calls on regional governments to support collaborative efforts in successfully combating the increasing incidence of dengue and calls on appropriate actions to achieve this.”

This was echoed by Dr Pratap Singhasivanon, Secretary-General of the Southeast Asian Ministers of Education Organisation Tropical Medicine and Public Health Network.

“By fostering greater cooperation between various agencies and organisations, we can maximise the use of our resources in raising dengue as a health priority in this most affected region,” he said.

The alarming rise of dengue cases shows no signs of reversing. Experts are warning that climate change, urbanisation and the effect of this year’s El Nino are combining to exacerbate the dengue problem in several Asian countries.

The arrival of the first dengue vaccine – which has already been approved and used in The Philippines – marks the beginning of a new chapter in the history of public health.

It is, perhaps, no surprise that the Charter calls on countries to develop and implement dengue vaccination programmes in concert with other control strategies.

The integrated approach that was to the fore at the Asia Dengue Summit is also strongly heard in the call-to-action which urges greater effort to combine the potential power of surveillance, vector control, communications and other tools to defeat the disease.

The coalition describes vaccines as a useful addition to existing dengue prevention and control programmes, and calls for further investment in research.

“It is imperative for research and development to continue in the field of dengue prevention and control, and to ensure related research initiatives which have long-term positive impacts, are funded sustainably,” said Dr In-Kyu Yoon, Director of the Dengue Vaccine Initiative.

Financial support for R&D is a crucial piece of the puzzle, according to the organisations behind the Charter.

“Sustainable financing models are integral to the success of dengue prevention and control programs,” says Dr Valentina Picot, Scientific and Research Advisor of Fondation Mérieux. “This has to be a shared responsibility between regional entities and global organisations such as the WHO, to assist countries in obtaining sustainable financing to support the implementation of vaccination programs as part of a holistic solution to alleviate dengue burden in the region.”

Meanwhile, the need for action in Asia is reinforced by data showing that Thailand recorded 140,000 dengue cases last year – the highest since the 1987 crisis when 170,000 people were affected. In Singapore, the number of cases is expected to exceed 30,000, eclipsing the 2013 record of 22,170.

For Asia, answers to the call-to-action cannot come quickly enough.

Asia Dengue Summit Charter

·      Calls on countries to develop and implement dengue vaccination programmes that are carefully controlled and closely integrated with other control strategies

·      Calls on countries to ensure that, if dengue vaccine is introduced, implementation programmes are monitored and evaluated for safety, effectiveness and acceptance with good communications, active surveillance, laboratory support and clinical management

·      Calls for integration of efforts by various initiatives and associations to monitor developments in vaccine and vector control implementation and to engage governments and international organisations for vaccine introduction in endemic countries

·      Calls for the political will and commitment to accelerate effective dengue prevention and control interventions, including strengthening health systems and ensuring sustainable financing

·      Calls on relevant organisations and institutions to continue performing and supporting research to further enhance the impact of vaccination, including biomedical and clinical research, mathematical modelling, implementation and operational research, and post-licensure studies

·       Calls on the WHO and other global and regional organisations and initiatives to give higher priority to dengue prevention and control, provide continued leadership, guidance and technical support to countries on the possible introduction of dengue vaccine, and assist with implementation strategies, as well as assisting countries in obtaining sustainable financing

 

View the Call-to-Action Charter