During the 1950s and 1960s, the Pan-American Health Organization adopted a public health strategy to fight dengue, which successfully reduced, and in certain cases eliminated, the disease in the Americas. However, with time this momentum was lost.
Over the past 50 years, dengue - which causes flu-like illness and can be life-threatening in severe cases - has spread from nine to over 100 countries, making it the most rapidly spreading vector-borne disease. The cases have risen from 15,000 per year in the 1960s to 390 million today. Over 40 percent of the world’s population is at risk from dengue. This has been a result of population growth, unplanned urbanization, lack of environmental sanitation, increased long-distance travel and ineffective mosquito control.
In the Americas, the continent I come from, dengue cases have gone from practically being non-existent to countries like Brazil, Mexico and Colombia being counted among the top 10 most endemic countries in the world. Dengue has become a major public health issue on the continent.
While the statistics are shocking, it is clear that there is insufficient investment put towards battling dengue. It does not receive the media attention it deserves and is generally out of the public eye. A combination of media neglect, lack of policy dialogue, limited investment in disease surveillance and long-term initiatives to fight dengue demonstrate that this silent disaster continues to have a low-profile among policy-makers and donors. As a result, individuals, families, children and communities continue to suffer the burden of this preventable disease, in silence.
It is time to understand where we have failed and bring the facts about dengue and methods to contain and reduce it into the open. We need to battle dengue, which has made its way from urban areas to rural ones, spreading across cities and towns of not only my continent but also other continents.
The key to the solutions is in everyone’s hands.
The mosquito that carries the dengue virus, aedes aegypti, primarily bites during the day and breeds mostly in man-made containers and pure water. Dengue is linked to climate – the virus replicates faster, the mosquito bites more frequently and survives longer in higher temperatures. Despite the limited research and evidence-based data to establish the impact of climate change and global warming on dengue transmission, it is probable that the disease will continue to spread to new geographical areas.
A combination of dengue awareness and knowledge - not only about its causes, effects and implications - but also the actions taken at every level will facilitate controlling the disease. National Red Cross and Red Crescent Societies are taking a step in this direction by empowering volunteers and communities with information and skills to reduce their health risks and ensure environmental sanitation. Mosquito control strategies must be tailored house-by-house, community-by-community and neighbourhood-by-neighbourhood. It is only by taking collective responsibility that we will be able to stop dengue from spreading and reduce the suffering caused by it.
In my previous experience with the Colombian Red Cross, I have seen the power and effectiveness of using participatory approaches and having volunteer presence in each community to provide preventive health and care services. This not only fosters community action but also enhances the collaboration between the community and the formal health system. This is particularly important in countries like Colombia and Mexico where certain areas cannot be accessed by public health authorities due to rampant violence.
POOREST BEAR THE BRUNT
Dengue is a debilitating disease affecting all segments of society. But the poorest and most vulnerable often bear the brunt of the disease, as they often live in areas with inadequate water supply and sanitation, where conditions are favourable for the mosquito to multiply. The most vulnerable often have limited access to healthcare and basic information regarding the disease.
The proportion of deaths among those who contract the disease is significant. About 2.5 percent of those affected from dengue die. However, without proper preventive health and care services fatality rates could exceed 20 percent.
The situation is further amplified due to the high associated costs, which can be twice as much, or even three times, the average monthly income of a person. On average, between 14.8 and 18.9 days are lost for each case of infection, as the patient is incapacitated or a family member needs to stay at home to care for sick children or relatives. The combined result of loss of income, decrease in productivity and the additional costs incurred due to medical expenses - the economic burden of the disease - erodes the resilience of those affected.
In turning up the volume on this silent disaster we are advocating for a complete shift in approach from responding to isolated outbreaks to investing in long-term programming, including community-level initiatives leading to sustainable behavioural change. We aim to prevent dengue from ever returning to the level it has reached today.
Each one of us – individuals, communities, governments, donors and partners – has a role to play in fighting this disease. Together we need to bring about a change. Only then can we build resilient communities and ensure that people are no longer abandoned to unnecessary silent suffering caused by dengue.
On Friday, the IFRC released a report showing how dengue has become a major public health issue. Read more on www.ifrc.org/dengue