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Global Strategy for Dengue Prevention and Control 2012-2020

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Global Strategy for Dengue Prevention and Control 2012-2020 TREATMENT, PREVENTION AND CONTROL 2O12–2O2O GLOBAL STRATEGY FOR DENGUE PREVENTION AND CONTROL Neglected Tropical Diseases (NTD) HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases (HTM) Avenue Appia 20, 1211 Geneva 27, Switzerland Fax: +41 22 791 48 69 www.who.int/neglected_diseases/en 2O12–2O2O GLOBAL STRATEGY FOR DENGUE PREVENTION AND CONTROL WHO Library Cataloguing-in-Publication Data Global strategy for dengue prevention and control 2012-2020. 1.Dengue – prevention and control. 2.Dengue – epidemiology. 3.Endemic diseases – prevention and control. 4.Disease outbreaks – prevention and control. 5.Mosquito control. 6.Health planning. I.World Health Organization. ISBN 978 92 4 150403 4 (NLM classification: WC 528) © World Health Organization 2012 All rights reserved. Publications of the World Health Organization are available on the WHO web site (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press through the WHO web site (http://www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Printed in France Design & layout: Patrick Tissot WHO/HTM/NTD iii CONTENTS FOREWORD ............................................................................................................................. iv EXECUTIVE SUMMARY ................................................................................................................ v 1. DENGUE: A GLOBAL THREAT – GLOBAL ANSWERS ..................................................................1 1.1 Burden of the disease ....................................................................................................1 1.2 Reversing the trend ........................................................................................................3 1.3 Opportunities for investment ...........................................................................................4 2. THE GLOBAL STRATEGY FOR DENGUE PREVENTION AND CONTROL .......................................6 2.1 Goal and objectives ......................................................................................................6 2.2 Overview of technical elements and enabling factors for implementation ..............................6 3. TECHNICAL ELEMENTS ..........................................................................................................8 3.1 Diagnosis and case management ....................................................................................8 3.2 Integrated surveillance and outbreak preparedness .........................................................10 3.2.1 Integrated surveillance ......................................................................................11 3.2.2 Outbreak preparedness ....................................................................................12 3.3 Sustainable vector control .............................................................................................14 3.4 Future vaccine implementation ......................................................................................16 3.5 Basic, operational and implementation research .............................................................18 4. ENABLING FACTORS FOR IMPLEMENTATION ........................................................................20 4.1 Advocacy and resource mobilization .............................................................................20 4.2 Partnership, coordination and collaboration ...................................................................20 4.3 Communication to achieve behavioural outcomes............................................................21 4.3.1 Communication in outbreak response .................................................................22 4.4 Capacity-building 4.4.1 Strengthening local management capabilities for informed decision-making ............23 4.5 Monitoring and evaluation ...........................................................................................23 REFERENCES ............................................................................................................................25 ANNEXES ............................................................................................................................28 ACKNOWLEDGEMENTS ...........................................................................................................34 iv FOREWORD In just the past decade, the significance of dengue as well beyond the health a threat to health and a burden on health services and sector. The Global economies has increased substantially. Compared with strategy promotes the situation 50 years ago, the worldwide incidence of coordinated action among dengue has risen 30-fold. More countries are reporting multisectoral partners, their first outbreaks. More outbreaks are explosive an integrated approach in ways that severely disrupt societies and drain to vector management, economies. Today, dengue ranks as the most important and sustained control mosquito-borne viral disease in the world. Everywhere, measures at all levels. the human and economic costs are staggering. Its guiding principle is to harmonize prevention, In a sense, this neglected tropical disease has taken the entomological and epidemiological surveillance, and world by surprise, with few coherent and coordinated case management with existing health systems, ensuring efforts, at national or international levels, undertaken that efforts are coherent, sustainable, cost-effective and to hold dengue at bay and reverse these alarming ecologically sound. trends. The Global strategy for dengue prevention and control, 2012–2020, aims to correct this situation. It This is a global strategy for a global threat. As we answers requests, by multiple WHO Member States, for have learned, dengue and its vectors travel well advice on how to move from a reactive response to an internationally. I challenge all partners to study the emergency situation to proactive risk assessment, early strategy, define their role, and engage with a fully warning systems, and preventive measures, guided by justified sense of urgency. As the strategy demonstrates, entomological as well as epidemiological surveillance. doing so will be highly rewarding. The overall message is upbeat and encouraging. Despite the complex clinical Above all, the Global strategy emphasizes the many manifestations of this disease, its management is relatively new opportunities, opened by country experiences and simple, inexpensive and highly effective in saving lives, recent research, also on vaccines, that can be seized to provided correct and timely interventions are instituted. reduce morbidity and mortality, rationalize the disease When these interventions are in place, mortality from response, and build capacities that increase resilience dengue can be reduced to zero. Let us make this our to future outbreaks. To this end, the document also overarching – and broadly shared – goal. serves as an investment case, spelling out the steps that can be taken to improve risk assessment and mapping, stockpiling and logistics, surveillance and diagnostic capacity, behavioural and social interventions, and risk communication. Dr Margaret Chan A complex disease like dengue demands a multi- Director-General pronged response that engages government ministries World Health Organization v EXECUTIVE SUMMARY Dengue is a major public-health concern throughout and training health personnel, along with appropriate tropical and sub-tropical regions of the world. It is the referral systems, at primary health-care levels. most rapidly spreading mosquito-borne viral disease, with a 30-fold increase in global incidence over the Dengue morbidity can be reduced by implementing past 50 years. The World Health Organization (WHO) improved outbreak prediction and detection through estimates that 50–100 million dengue infections occur coordinated epidemiological and entomological each year and that almost half the world’s population surveillance; promoting the principles of integrated lives in countries where dengue is endemic. While vector
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