PRESENTATION: Dengue in Western Pacific Region – A need for urgent action by Dr, Mark Jacobs, WHO
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Transcript of PRESENTATION: Dengue in Western Pacific Region – A need for urgent action by Dr, Mark Jacobs, WHO
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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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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
.
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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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 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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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
Increasing dengue burden in region
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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
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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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
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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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
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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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
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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Managing Regional Public Goods for Health Community Based Dengue Control
12 September 2013, Manila, Philippines
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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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
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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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
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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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
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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Managing Regional Public Goods for Health Community Based Dengue Control
12 September 2013, Manila, Philippines
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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Managing Regional Public Goods for Health Community Based Dengue Control
12 September 2013, Manila, Philippines
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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Managing Regional Public Goods for Health Community Based Dengue Control
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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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Managing Regional Public Goods for Health Community Based Dengue Control
12 September 2013, Manila, Philippines
Thank you.