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2 12–2 2 GLOBAL STRATEGY FOR DENGUE …

TREATMENT, PREVENTION AND CONTROLTREATMENT, PREVENTION AND CONTROL2O12 2O2 ONeglected Tropical Diseases (NTD)HIV/AIDS, Tuberculosis, malaria and Neglected Tropical Diseases (HTM) Avenue Appia 20, 1211 Geneva 27, SwitzerlandFax: +41 22 791 48 STRATEGY FOR DENGUE PREVENTION AND CONTROL2O12 2O2 OGLOBAL STRATEGY FOR DENGUE PREVENTION AND CONTROLWHO Library Cataloguing-in-Publication DataGlobal STRATEGY for DENGUE prevention and control prevention and control. epidemiology. diseases prevention and control. outbreaks prevention and control. control. planning. Health 978 92 4 150403 4 (NLM classification: WC 528) World Health Organization 2012 All rights reserved.

TREATMENT, PREVENTION AND CONTROL 2O12–2O2O Neglected Tropical Diseases (NTD) HIV/AIDS, Tuberculosis, Malaria and Neglected Tropical Diseases (HTM) Avenue Appia 20, 1211 Geneva 27, Switzerland

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Transcription of 2 12–2 2 GLOBAL STRATEGY FOR DENGUE …

1 TREATMENT, PREVENTION AND CONTROLTREATMENT, PREVENTION AND CONTROL2O12 2O2 ONeglected Tropical Diseases (NTD)HIV/AIDS, Tuberculosis, malaria and Neglected Tropical Diseases (HTM) Avenue Appia 20, 1211 Geneva 27, SwitzerlandFax: +41 22 791 48 STRATEGY FOR DENGUE PREVENTION AND CONTROL2O12 2O2 OGLOBAL STRATEGY FOR DENGUE PREVENTION AND CONTROLWHO Library Cataloguing-in-Publication DataGlobal STRATEGY for DENGUE prevention and control prevention and control. epidemiology. diseases prevention and control. outbreaks prevention and control. control. planning. Health 978 92 4 150403 4 (NLM classification: WC 528) World Health Organization 2012 All rights reserved.

2 Publications of the World Health Organization are available on the WHO web site ( ) 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: 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 ( ).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.)

3 Dotted lines on maps represent approximate border lines for which there may not yet be full 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 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.

4 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/NTDiiiCONTENTSFOREWORD .. ivEXECUTIVE SUMMARY .. v1. DENGUE : A GLOBAL THREAT GLOBAL ANSWERS ..1 Burden of the disease ..1 Reversing the trend ..3 Opportunities for investment ..42. THE GLOBAL STRATEGY FOR DENGUE PREVENTION AND CONTROL ..6 Goal and objectives ..6 Overview of technical elements and enabling factors for implementation ..63. TECHNICAL ELEMENTS ..8 Diagnosis and case management ..8 Integrated surveillance and outbreak preparedness ..10 Integrated surveillance.

5 11 Outbreak preparedness ..12 Sustainable vector control ..14 Future vaccine implementation ..16 Basic, operational and implementation research ..184. ENABLING FACTORS FOR IMPLEMENTATION ..20 Advocacy and resource mobilization ..20 Partnership, coordination and collaboration ..20 Communication to achieve behavioural Communication in outbreak response ..22 Capacity-building Strengthening local management capabilities for informed decision-making ..23 Monitoring and evaluation ..23 REFERENCES ..25 ANNEXES ..28 ACKNOWLEDGEMENTS ..34ivFOREWORDIn just the past decade, the significance of DENGUE as a threat to health and a burden on health services and economies has increased substantially.

6 Compared with the situation 50 years ago, the worldwide incidence of DENGUE has risen 30-fold. More countries are reporting their first outbreaks. More outbreaks are explosive in ways that severely disrupt societies and drain economies. Today, DENGUE ranks as the most important mosquito-borne viral disease in the world. Everywhere, the human and economic costs are a sense, this neglected tropical disease has taken the world by surprise, with few coherent and coordinated efforts, at national or international levels, undertaken to hold DENGUE at bay and reverse these alarming trends. The GLOBAL STRATEGY for DENGUE prevention and control, 2012 2020, aims to correct this situation.

7 It answers requests, by multiple WHO Member States, for advice on how to move from a reactive response to an emergency situation to proactive risk assessment, early warning systems, and preventive measures, guided by entomological as well as epidemiological surveillance. Above all, the GLOBAL STRATEGY emphasizes the many new opportunities, opened by country experiences and recent research, also on vaccines, that can be seized to reduce morbidity and mortality, rationalize the disease response, and build capacities that increase resilience to future outbreaks. To this end, the document also 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 complex disease like DENGUE demands a multi-pronged response that engages government ministries well beyond the health sector.

8 The GLOBAL STRATEGY promotes coordinated action among multisectoral partners, an integrated approach to vector management, and sustained control measures at all levels. Its guiding principle is to harmonize prevention, entomological and epidemiological surveillance, and case management with existing health systems, ensuring that efforts are coherent, sustainable, cost-effective and ecologically sound. This is a GLOBAL STRATEGY for a GLOBAL threat. As we have learned, DENGUE and its vectors travel well internationally. I challenge all partners to study the STRATEGY , define their role, and engage with a fully justified sense of urgency.

9 As the STRATEGY demonstrates, doing so will be highly rewarding. The overall message is upbeat and encouraging. Despite the complex clinical manifestations of this disease, its management is relatively simple, inexpensive and highly effective in saving lives, provided correct and timely interventions are instituted. When these interventions are in place, mortality from DENGUE can be reduced to zero. Let us make this our overarching and broadly shared Margaret ChanDirector-GeneralWorld Health OrganizationvEXECUTIVE SUMMARYand training health personnel, along with appropriate referral systems, at primary health-care morbidity can be reduced by implementing improved outbreak prediction and detection through coordinated epidemiological and entomological surveillance; promoting the principles of integrated vector management and deploying locally-adapted vector control measures including effective urban and household water management.

10 Effective communication can achieve behavioural outcomes that augment prevention programmes. Research will continue to play an important role in reversing the trend in DENGUE , a neglected tropical disease, by improving methods and systems for surveillance, prevention and the trend requires commitments and obligations from partners, organizations and countries, as well as leadership by WHO and increased funding. Fund-raising is probably best addressed by a combined effort, with consideration for DENGUE as a public health problem in countries with substantial local and national funding resources that must be effectively channelled through sound technical support.


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