Upcoming strategic plan hopes to tackle rising dengue cases worldwide

Channel NewsAsia 5 May 08;

SINGAPORE: Dengue cases face a rising trend worldwide and hopefully the upcoming Asia-Pacific Dengue Strategic Plan will help countries tackle the disease.

Some 80 international officials from various environment and health ministries are here for a five-day meeting to finalise the plan. The plan's objectives include strengthening collaboration to control dengue and sharing resources in this area.

It will also provide a framework for countries such as Thailand and Malaysia to develop their own anti-dengue programmes.

Environment and Water Resources Minister, Dr Yaacob Ibrahim, said: "Dengue does not respect international boundaries. As such, dengue control efforts cannot be limited to one country or a few countries and must be co-ordinated as a regional endeavour in order to be truly effective.

"Having a comprehensive regional dengue strategic plan is certainly a big step in the right direction towards the region's collective battle against dengue."

This is crucial because many governments today neglect the dengue problem.

Dr John Ehrenberg, Regional Adviser, Western Pacific Region, World Health Organisation, said: "They are very much preoccupied with diseases that have high mortality rates. Malaria, tuberculosis, HIV/Aids are diseases that attract a lot of attention, and so they tend to worry about dengue only when you have an outbreak.

"Our goal is really to raise the level of awareness towards the problem of dengue and be able to pay attention between outbreaks, not just during the outbreaks."

The global dengue incidence has increased 30-fold in the last 50 years. Today, dengue is endemic in more than 100 countries, where up to three billion people are at risk.

Singapore is also affected, registering 1,616 dengue cases in the first four months of this year, an increase of 421 cases from 1,195 cases in the same period last year.

Khoo Seow Poh, Director-General of Public Health, National Environment Agency, said: "Singaporeans are generally quite aware of what's dengue and they also know how to go about preventing mosquito breeding in their homes.

"But the question is how to make it a habit, make sure they do it on a routine basis, especially now (that) the weather is turning warmer. So there's a need for every household to be vigilant and do their part in keeping their homes free of mosquito."

In the fight against dengue, Singapore plans to host a regional training workshop here at the end of this year. This will allow international experts to come together and share experiences on tackling the disease.

Singapore will also share its knowledge in dengue prevention - such as in the area of surveillance and community mobilisation. - CNA/vm

Experts ganging up to fight dengue scourge

WHO and NEA to set up workshop on monitoring disease at year's end
Tan Hui Leng, Today Online 6 May 08;

With the global incidence of dengue increasing 30-fold in the last 50 years and Asia bearing 70 per cent of the global disease burden, the need for a regional training workshop in which experts from the region and other parts of the world share and learn from one another has never been greater.

Such an annual workshop will be set up here at the end of the year as a collaborative effort between the World Health Organisation (WHO) and the National Environment Agency (NEA).

"Singapore has spearheaded a number of initiatives, a number of strategies and techniques to put in place a very innovative surveillance system, and it's something we would like to take a look at as the potential for other countries in the world," said Dr John Ehrenberg, WHO Western Pacific Regional Adviser.

Ironically, even as Singapore is held up as a role model of dengue surveillance and monitoring, it is suffering from a dengue scourge.

In the first four months of the year, there has an increase of 35 per cent in dengue cases over the same period last year. Last week alone, there were 118 cases. As the warmer months from June to September approaches, the NEA is bracing for the traditional peak dengue period.

"We cannot eliminate dengue," said Dr Ehrenberg. "What we can do is control it, we can lessen the damage and this country has shown it can do that."

Singapore will offer sites for the sharing of both field and laboratory experiences, covering topics ranging from surveillance, vector control to community mobilisation, said Environment and Water Resources Minister Yaacob Ibrahim yesterday at the opening of the Asia-Pacific Dengue Programme Managers meeting.

The meeting, which is being held at the Amara Hotel, is being attended by 75 dengue experts from 22 countries.

During the five-day meeting, delegates will finalise the Asia-Pacific dengue strategic plan, which will suggest, among other things, ways to implement monitoring and response systems to better predict and react to outbreaks. The first draft of the plan, was reviewed in Phuket in September.

The WHO hopes that governments in the Western Pacific and South-east Asian countries will endorse the plan by September and commit more funds towards its implementation. This roadmap is part of the Asia-Pacific Dengue Partnership, formed in March 2006.

This is especially important in the developing world where there is a tendency to focus more on diseases such as malaria and tuberculosis rather than dengue.

Even in Singapore, awareness does not always lead to corrective action.

This year (until April 26), the number of mosquito breeding habitats in residential sites showed a 33-per-cent increase over the same period last year; at construction sites, there was a 46-per-cent increase.

"The software part — we need to put in more effort," said Mr Khoo Seow Poh, NEA director-general of public health. "That will help a lot in reducing the number of cases and cutting down chances of transmissions."

Dengue war: Singapore joins 21 countries to beat bug
Liaw Wy-Cin, Straits Times 6 May 08;

AS SINGAPORE attempts to stave off what could be its worst dengue fever epidemic, it has joined hands with 21 other countries in the Asia-Pacific region to draw up an ambitious eight-year battle plan against the disease.

This is the largest regional tie-up, said Dr John Ehrenberg, the World Health Organisation's (WHO) Western Pacific regional adviser of malaria, other vector-borne and parasitic diseases.

Details of the Asia-Pacific Dengue Strategic Plan are being finalised during a week-long meeting, which began at the Amara Hotel yesterday and involves 75 regional representatives.

By Friday, they hope to pin down strategies on gathering, recording and analysing data, treating patients and combating the dengue-spreading Aedes aegypti, among other things.

What is crucial is that the plan, to be presented to regional health ministers in September, is compelling enough to draw both the funds and political will to fight the disease, said Dr Ehrenberg.

It also has to include the whole region, since the disease respects no borders, added Dr Michael Nathan, chief of vector ecology and management at WHO's department of control of neglected tropical diseases.

'It is an urban disease - a product of our global village, where people move around a lot,' he said.

During the meeting, countries will draft national-level plans. That is where they can draw from each other, said Mr Khoo Seow Poh, director-general of public health at the National Environment Agency, adding that Singapore hopes to pick up ideas on surveillance, community mobilisation and changing people's behaviour.

In the first 18 weeks of this year, Singapore has seen 1,734 dengue cases - about 36 per cent more than the same period last year. At least 26 cases were of the more serious type - dengue haemorrhagic fever.

Last month, the NEA warned that unless the trend of infections is halted, the number of sick people could hit record levels in three years' time.

The Asia-Pacific is the most dengue-riddled region in the world, and accounts for more than 70 per cent of dengue cases, says the WHO.

Some 50 million to 100 million cases of dengue have been reported worldwide each year - 30 times higher than 50 years ago.

Dengue is not the only worry, said Singapore's Minister for the Environment and Water Resources Yaacob Ibrahim, pointing to other mosquito-borne diseases like chikungunya.

Chikungunya has affected more than one million people since 2005. It first appeared here in 2006, although all the cases were imported. Singapore saw its first locally transmitted cases this year.

What compounds the problem is that tackling dengue may not be a priority for some countries, which find diseases like tuberculosis and HIV more pressing, said Dr Ehrenberg.

That is why both adequate resources and political will are needed to back such a plan, dengue expert Duane Gublertold The Straits Times.

Either way, effective dengue prevention and control requires the region to work together, he said.