The MENTOR Initiative: championing an integrated response to dengue outbreaks worldwide
Dengue fever is the world’s fastest growing infectious disease. Figures from the WHO estimate that “3.9 billion people in 128 countries are at risk of infection with dengue viruses”[1], posing a burden that is “30 times greater [today] than 50 years ago”[2] and “infecting more people than malaria, zika, and yellow fever combined”.
Still, dengue fever doesn’t generally evoke the same type of visceral concern afforded to diseases like malaria or Ebola, despite the more severe dengue haemorrhagic fever manifesting symptoms strikingly close to Ebola. This is due in part to the historically relatively recent rise of dengue into our collective awareness, but also due to a general perception of the infection being somehow less severe in the spectrum of tropical disease. What this attitude misses however (aside from the very real and severe cases of dengue haemorrhagic fever), is the vast socioeconomic impact of non-fatal infections on a wide scale; something that messaging within the vector-borne and tropical disease sector is still learning to integrate effectively. The world’s fastest growing infectious disease not only costs an estimated USD $8billion per year, but leaves untold costs in its wake through lost productivity and hampered potential in the lives of those affected. It is precisely for the growing awareness of this intersection between disease response/control and economic development that a World Dengue Day would be so crucial, and could potentially spark a whole new spectrum of public/private sector investment in vector-borne disease control, similar to what we’ve seen in malaria campaigns led by petroleum companies or the like.
The battle with dengue is gaining a stronger seasonal foothold in Africa; a continent already ravaged by a spectrum of other tropical diseases, and where the primary vector of the disease, the Aedes aegypti mosquito, is already widely endemic. Unfortunately, the Long-Lasting Insecticidal Net (or Insecticide Treated Net), a traditionally favoured tool for managing mosquito vectors designed for night-time use, is largely ineffective for this breed of mosquito which favours daytime feeding, requiring a concerted re-education component of any Information, Education, & Communication campaigns. Until a suitable vaccine for dengue is discovered and market-ready, the best preventative response to the disease is to clear the
immediate environment from potential mosquito breeding sites, a process which requires considerable training and collaborative effort from the at-risk community. The MENTOR Initiative facilitates this kind of training, both for the communities directly affected and for the partner and stakeholder organisations sharing this space, and offer our Integrated Vector Management (IVM) toolkit (co-produced with USAID) freely on our website, outlining everything from the diseases, their vectors, and the appropriate means of control from the individual to the national level. The best tool we have in this battle is education which changes behaviour. Education requires raising awareness. World Dengue Day is a perfect platform and catalyst for such.
The MENTOR Initiative has been responding to dengue fever outbreaks since very early in its lifetime. From our response to natural emergencies in Yogyakarta, Indonesia in 2006, to Yangon City, Myanmar in 2008, to Port au Prince, Haiti in 2010, we have brought pragmatic and effective Integrated Vector Management tools to the frontline of the battle with dengue fever, helping millions of at-risk people. Today, we continue this fight with programmes in Wajir
and Mandera, Kenya, helping protect over a million people and counting since 2011. Employing IVM tactics ranging from scrubbing water storage tanks (where mosquito eggs/larvae/pupae may be hiding), to larviciding containers where standing water might be stored or gather (like decorative vases or old tyres), or from clearing refuse where standing water breeding grounds may be problematic, to deploying plastic sheeting infused with insecticide when building temporary shelters, or simply providing education, materials and toolkits; MENTOR has met the dengue problem head on with effective and efficient tactics. As large an impact as we’ve had, however, there simply aren’t enough resources being made available to adequately tackle this disease, let alone its place within the rest of the range of tropical and vector-borne diseases needing a response.
Bringing together all of these realities into an active campaign to improve awareness, advocacy, investment into and control of dengue fever is needed if we are serious about stopping the insidious threat of dengue worldwide.
References
[1] http://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue
[2] https://www.breakdengue.org/breaking-dengue-perspectives/?tab=chapter2
