Dengue remains to be a major public health problem in the Philippines. But it is reassuring to know that medical science has continued to develop and is working on real solutions, such as new vaccines and other novel and ingenious solutions that address the dengue crisis head on.
The inaugural Dengue Forum titled “Addressing the Mosquito in the Room” held last Wednesday, 27 September, aimed to amplify the conversation on dengue as a public health concern in the Philippines. The event was organized by RiseAboveNow Business Consulting Group (RAN-BCG) and was supported by the Embassy of Japan in the Philippines and the Department of Health (DOH).
Between 1 January and 9 September of this year, 125,975 dengue cases were reported across the nation, so far lower compared to cases in the last five years. Since mid-June 2023, 5,000 cases have been registered on an average every week, according to the Department of Health (DOH), Philippines. Despite the plateauing dengue cases, the DOH is not shutting down the possibility of an uptick in cases during the coming the rainy season.
The present impact of dengue was described in the recent dengue forum “Addressing the Mosquito in the Room”: The forum gathered a panel of experts from various relevant fields from both relevant government agencies, as well as from the private sector. It aimed to raise the alarm on the already ongoing Dengue Crisis, assess the extent of the burden at this time, map out a multi-sectoral strategy, but perhaps most importantly, to discuss new developments globally on newly introduced solutions that can make a real impact in ending the dengue crisis. This dengue forum was also an opportunity to establish a robust platform for multi-stakeholder collaboration in addressing the dengue situation in the country.
In an official statement, Secretary of the Department of Health (DOH) Teodoro J. Herbosa, MD, emphasized the urgency of the event, and the importance of a holistic approach: “This event carries profound significance as it highlights the importance of a Philippine Collaborative response framework. Dengue is a self-limiting disease, there is currently no definitive therapy or regimen available,” he stressed. With the COVID-19 threat now effectively mitigated, dengue now looms as the one of the most prevalent health concerns in tropical countries such as the Philippines.
Dr. Jose Rene de Grano, MHA, president of the Private Hospitals Association of the Philippines, and pediatrician Dr. Maria Fatima Gualberto of Otsuka Solar Phils. Inc. of Japan shared that dengue was among the leading causes of hospitalization in the post COVID-19 era. While Dr. Kim Patrick Tejano of DOH Disease Prevention and Control Bureau pointed out that dengue was the second biggest health condition in terms of cost for PhilHealth claims nationwide in the last year.
Meanwhile Ms. Angelica Garcia of the DOH Epidemiology Bureau, shared the alarming truth, that statistically, 56% of all dengue fatalities are children 9 years old or younger. Furthermore, 70% of all dengue cases are people 19 years old or younger.
Representatives from Local Government Units where dengue incidence was relatively low namely Pasig, Caloocan, Quezon City and Baguio shared their best practices in the area of vector control, or eradication of mosquitoes, emphasizing adherence to the Five S method of controlling dengue: Search and destroy, Self-protect, Seek consultation, Support fogging, Sustained Hydration.
New hope, a LOT of new hope.
However, the most promising news came from the medical experts on hand, who shared that there are in fact new weapons that are available in the war against dengue. Consultant to the DOH and eminent infectious disease authority, Dr. Rontgene Solante fully acknowledged the need for stringent vector control, but he cautioned: “If you focus only on vector control, there is a possibility that it can also reduce herd immunity.” Dr. Solante then shared that there are in fact second-generation dengue vaccines, one that is actually already licensed for use in over 30 countries, including ASEAN neighbors Indonesia and more recently Thailand.
This vaccine are far more advanced than the previous generation. They can be administered safely to people whether or not they have previously had dengue. Numbers are also significantly better than 1st gen vaccine. Solante shared that the TAK003 vaccine already licensed in over 30 countries are 80.2% effective at preventing dengue infection, compared to just 56% for first gen vaccine, it is also 95.4% effective at preventing severe dengue, whereas first generation vaccine had only 91% efficacy.
Dr. Solante shared that the reason behind the superiority of 2nd generation vaccines was that they were engineered on a dengue virus backbone, whereas the 1st generation was built on a Yellow Fever backbone. This is also the reason why 2nd gen vaccines are effective even for those who have never had dengue.
Despite the promise of an effective vaccine, Dr. Solante echoed Secretary Herbosa’s opinion: “Vector control, environmental control, patient education, awareness, even updates in the clinical management are all part of what we call an integrated approach and a vital part of this will be vaccination. So, this is what we call a comprehensive strategy. You have vaccination, as well as vector control.”
TAK003 is manufactured by global, research and development-driven pharmaceutical company Takeda. Takeda was represented at the forum along with three other Japanese firms and no less than Minister for Economic Affairs at the Embassy of Japan in the Philippines, Mr. NIHEI Daisuke who affirmed Japan’s commitment to help ease the global burden of dengue: “We also consider dengue as an international concern, and we are one with the Philippines in your fight against this disease.”
TAK003 vaccine was also recently recommended by the World Health Organization’s Strategic Advisory Group of Experts (SAGE) for introduction in settings with high dengue disease burden and high transmission intensity to maximize impact to public health and that the vaccine introduction should be accompanied by a well-designed communication strategy and community engagement.
New vaccines are not the only new development, Dr. Anna Lisa Ong-Lim, Chief of the Division of Infectious and Tropical Disease at the Philippine General Hospital shared that there is in fact promising news in the area of developing antivirals that could both provide immunity and cure already infected patients. In her presentation, Dr. Ong-Lim shared both the action of the antivirals in development, as well as what stage of trials they have already shown promise in.
While sharing the promise of new developments, Dr. Ong-Lim also talked about simple yet ingenious best practices that have worked worldwide, such as mosquito nets that are used to cover entire small villages. She did reiterate the importance of vaccine, but also pointed out how much more effective these would be if combined with other tactics: “Of course, we know that vaccines are known to be the most efficient approach to be able to target big numbers in these kinds of conditions, but when vaccines are complemented by therapeutic agents, you can even [have] better control.”
Ultimately with these new developments, it will be possible to bring dengue numbers down to insignificant levels. To make dengue vaccination widespread though, will require that every Filipino learn more about this disease and demand that any and all means be used to end this crisis.