Inaugural Address by Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia at the Informal Expert Consultation on Vector Borne Diseases
WHO Regional Office for South-East Asia, New Delhi, India, 7–8 April 2014
Distinguished experts and Colleagues,
It is my pleasure to welcome you all to this informal consultation on vector-borne diseases which coincides with the theme of World Health Day 2014. WHO celebrates World Health Day every year to focus global attention on a disease of common interest to all of us. In the context of the South-East Asia Region, this year’s theme on vector-borne disease is very apt and timely.
Vector-borne diseases are an important group of diseases, killing over a million people annually and putting half the world’s population at risk. These often neglected diseases account for 17% of the global estimated burden of all infectious diseases. Vector-borne diseases involve diverse group of parasites and viruses, spreading to humans through the bite of a diverse group of vectors, including mosquitoes, bugs, ticks, mites, flies and freshwater snails. These vectors are versatile creatures rapidly adapting to changing ecological and environmental conditions, thus challenging the control interventions available.
Malaria is endemic in all Members States of the Region, except Maldives, putting around 1.4 billion people at risk. WHO estimates 42 million cases and 27 000 deaths from malaria in the Region in 2012. Around 1.8 million people in the Region are at risk of dengue. In 2012 there were over 257 000 cases reported from the Region, which includes countries with the highest contribution to global dengue cases. Around 875 million people in the Region are at risk of lymphatic filariasis – the highest contribution to the global burden, with an estimated 60 million infected people. Kala-azar is endemic in Bangladesh, India and Nepal, with an estimated 100,000 cases annually, while sporadic cases are being reported from Bhutan and Thailand. An estimates 70,000 cases of Japanese encephalitis with 15,000 deaths are reported annually in the Region. Schistosomiasis persists in two districts of Central Sulavesi in Indonesia.
The Region has been making progress in controlling and eliminating most of the vector-borne diseases. Malaria prevalence continues to decline, with five countries achieving more than 75% decrease in case incidence and two additional countries expected to achieve this target by 2015. Sri Lanka is in elimination phase with no locally acquired cases since November 2012, while Bhutan and the Democratic People’s Republic of Korea are in the pre-elimination phase. Bhutan and the Democratic People’s Republic of Korea continue to remain free from lymphatic filariasis and Maldives, Sri Lanka and Thailand are working
on submitting the dossier for certification of LF elimination. Bangladesh, India, Myanmar and Nepal are making good progress in reaching the LF elimination target. Bangladesh and Nepal is making good progress in eliminating kala-azar, and India is committed to reaching the regional target.
However, there are still many challenges in eliminating these diseases as issues of public health concern. Environmental degradation and poor solid-waste management is creating more mosquito breeding grounds than ever. Global warming and climate change are pushing vectors to new locations and higher altitudes while increasing the efficiency of the mosquitoes as vectors. Dengue and chikungunya keep on increasing in the Region. The emergence of malaria parasite resistance to medicines threatens progress, while vectors developing resistance to insecticides are posing greater challenges. While countries continue to make progress in eliminating the diseases, sustaining control measures and strengthening surveillance remain an issue. National capacities to meet these challenges need to be strengthened and communities must be educated and empowered to prevent these diseases. We need better tools to reach out to the difficult-to-reach pockets in countries. While efforts to develop a dengue vaccine continue, we need to discuss how we can better understand the epidemiology and pathophysiology of the disease and sustain improvements in case management. We need better data and stronger evidence on the disease burden and its health, social and economic impacts. We need to explore creative ways of working together both within and between countries. I hope this two-day consultation will advise and guide us on some of these issues and beyond, enabling us to better focus our agenda in controlling and eliminating vector-borne diseases. We seek technical support for us from all the institutions and WHO collaborating centres.
I am also very pleased to know that all WHO collaborating centres working on vector-borne diseases located in the Region are represented in this meeting. I hope you all had a pleasant journey and your stay here in New Delhi is comfortable.