presentation: dengue in western pacific region – a need for urgent action by dr, mark jacobs, who

7/29/2019 PRESENTATION: Dengue in Western Pacific Region A need for urgent action by Dr, Mark Jacobs, WHO

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Managing Regional Public Goods for Health Community Based Dengue Control

12 September 2013, Manila, Philippines

Dengue in Western Pacific Region

A need for urgent action

Dr Mark Jacobs

Director, Control of Communicable Diseases,Regional Office for the Western Pacific

Disclaimer: The views expressed in this paper/presentation do not necessarily reflect the

views or policies of the Asian Development Bank (ADB), or its Board of Governors, or the

governments they represent. ADB does not guarantee the accuracy of the data included inthis paper and accepts no responsibility for any consequence of their use. Terminology used

may not necessarily be consistent with ADB official terms.


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.

In just the past decade, the significance of dengue as a threatto health and a burden on health services and economies has

increased substantially. Compared with the situation 50 years ago, the

worldwide incidence of dengue has risen 30-fold. More countries are

reporting their first outbreaks. More outbreaks are explosive in ways

that severely disrupt societies and drain economies. Today, dengueranks as the most important mosquito-borne viral disease in the

world. Everywhere, the human and economic costs are staggering.

- Dr Margaret Chan, Director-General,

World Health Organization.


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Dengue factors contributing to present

critical situation

Five fold increase in disease burden over last 5 decades globallyand increasing mortality

Presence of four sero-types with no cross protection -i.e. people can

get infected more than once

Vectors are well adapted to human environments in both urban and

rural

Climate change possibly contributing to increasing geographic

distribution and abundance of vectors

Absence of specific treatment (only supportive) or a vaccine


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Increasing dengue burden in region


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Increasing number of annual deaths

0

200

400

600

800

1000

1200

1400

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011


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Increasing number of WPR countries reporting

dengue cases

Countries reporting dengue in year

2000 (17 out of 37 = 46%)

Countries reporting dengue in year

2011 (24 out of 37 = 65%)


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Expansion of countries/territories reporting

dengue

Countries/territories that reported dengue in Year 2011 (but not in year 2000)

Marshall Islands

Federated States of Micronesia

New Zealand

Brunei Darussalam

Macao (China)

Papua New Guinea

Vanuatu


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Countries/territories with highest burden of

disease

Asia subregion

Cambodia

Lao PDR

Malaysia

Philippines

Singapore

Vietnam

Pacific subregion

Cook Islands

French Polynesia

Micronesia

New Caledonia

Solomon Islands


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Economic impact of dengue

Asia-Pacific bears 75% of current global disease burdenfrom dengue, estimated at 50 -100 million cases annually.

ASEAN region has highest number of dengue infections in

Asia-Pacific. Significant impact on socio-economic status

of Member States.

In Cambodia, out of pocket expenditure on dengue

patients left up to 1/3 of affected households with

continued debt burden even one year after an outbreak.


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Distribution of global dengue risk

Determination of risk status based on combined reports from WHO, the United States Centers for Disease Control and Prevention, Gideon

online,ProMED, DengueMap, Eurosurveillance and published literature (Simmons CP et al, 2012).

Suitability for Dengue

Transmission

High suitability

Low suitability

Unsuitable or

nonendemic


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New Global Strategy for Dengue Control

2012 - 2020

Goal of global strategy is to reduce burden of dengue. Specific objectives are to reduce mortality and morbidity from dengue by 2020 by at least 50%

and 25% respectively (using 2010 as the baseline). Objectives can be achieved by applying

existing knowledge.

Global strategy provides both technical elements and enabling

factors for implementation that are necessary to reverse growingtrend in number of dengue cases.

Applying existing knowledge for dengue prevention and control will

require collaboration among partners, organizations and countries,

leadership by WHO and increased funding.


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Strategies for reducing morb id i ty

Implementing improved outbreak prediction and detectionthrough coordinated epidemiological and entomological

surveillance;

Promoting principles of integrated vector management;

Deploying locally-adapted vector control measures,

including effective urban and household water

management;

Communication to encourage behavioural outcomes in

prevention programmes.


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Strategies for reducing mortal i ty

Implementing early case detection and referral systems forpatients;

Managing severe cases with appropriate treatment;

Reorienting health services to cope with dengueoutbreaks;

Training health personnel at all levels of health system.


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Enabling factors for implementation of

Global Strategy

1) Advocacy and resource mobilization;

2) Partnership, coordination and collaboration;

3) Communication to encourage behavioural outcomes;

4) Capacity building;

5) Monitoring and evaluation.


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Key messages

We need to act together at regional level focusing on high-prioritycountries.

We need to strengthen existing partnerships and forge new

partnerships.

We need to mobilize sustainable resources at regional and country

level.

Countries need to be proactive rather than reactive.

Dengue will be with us for foreseeable future, but action can andshould be taken to reduce its impact


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Thank you.

presentation: dengue in western pacific region – a need for urgent action by dr, mark jacobs, who

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