Infectious Thoughts interview
World Health Organisation
Interview by Marianne Comparet (ISNTD)
Mathieu Bangert is Technical Officer in the Department of Neglected Tropical Diseases at the World Health Organisation, the department responsible for developing multisectoral approaches to the control of NTDs. At the recent Global NTD Partners Meeting in Geneva in April 2017, celebrating both 10 years of multi-stakeholder collaboration in NTD control as well as the launch of the WHO’s latest report “Integrating neglected tropical diseases in global health and development”, the ISNTD caught up with Mathieu Bangert to discuss the role of vector control in the global control, elimination and eradication of several vector-borne NTDs.
Thank you, Mathieu, for joining us for this ISNTD interview, here in Geneva. Could you introduce yourself and your role as technical officer at the WHO?
I work in the Department of Control of Neglected Tropical Diseases at the WHO where I work both in epidemiology of vector-borne disease and also support the health economist in evaluating NTD control strategies. While there are several vector-borne diseases in the department, I am focusing on dengue control. Currently, we are very excited to be driving the global vector control response which looks at increasing and integrating vector surveillance and control capacity across all vector borne diseases addressed by various groups at the WHO into one global response.
A shared view among our partners and members working in vector control is that the effort in this field can often be a reactive and short-term response to outbreaks. The WHO has been taking the lead to unify a more long-term protocol & methodology to tackling vector-borne diseases - is this something that you have been focusing on specifically, and what can we expect in the near future.
You are right that the community is very reactive to outbreaks. Starting with the chikungunya outbreak in the Caribbean, the persistent dengue epidemics we see in all WHO regions and most recently with zika and yellow fever - we are always chasing after outbreaks. So what we are working on is to present evidence to governments so they switch from responsive vector control to sustained and integrated vector control. We do this by showing the impact on epidemiology and vector populations if you have a sustained approach to vector control – but there is also a strong financial benefit from investing a regular amount of money over the year as opposed to having to quickly mobilise resources at short notice during an outbreak.
So, a double approach: one mobilising political will by keeping governments engaged in vector control, as well as the financial argument – a very well-rounded and compelling approach. As the WHO celebrates the launch of the new report on progress on NTD control this week in Geneva, do you feel that vector control as a strategy for NTD control has been sufficiently highlighted?
We were very happy to hear our Director General Margaret Chan discuss the importance of vector control for these diseases. At last year’s World Health Assembly, representatives of member states also brought up dengue as a big burden and issue for them. In addition, in the discussions on the financing of NTD control strategies, partners are bringing up vector control as an important aspect to consider. So I do feel that vector control is becoming more of a priority, both for the WHO as well as directly for member states. We need to approach vector control strategically, both in terms of financing and the technical aspects in order to respond to these outbreaks.
Building on this momentum, are there new partners which you would like to see entering this space? You spoke of the importance of mobilising governments - what about the private sector in endemic countries? For example, do you feel private companies making and distributing insecticides are sufficiently engaged in terms of overall public health strategies?
As you know we are working under the UN Sustainable Development Goals framework. What we are pushing for is precisely a greater collaboration with other sectors for example urban planning – this is represented by the safe cities SDG goal and we would like to see the city planners and organisations working on these issues to also include vectors and their risks as an integral part of their vision.
Water, sanitation & hygiene, which is embedded in the SDG 6, is another sector where we need to continue in our partnerships. For example, if messages are already being delivered to communities about improving water, sanitation and hygiene, this should also include messages about protecting your water sources from mosquito breeding, and training on getting rid of stagnant water sites. Another example is that providing piped water doesn’t just impact on the prevalence of for example soil-transmitted helminths – it also has an impact on vector populations as households do not need to store water which can serve as potential breeding sites. These are the kinds of relationships that we would like to strengthen, with a focus on involving local communities and community workers.