Dengue is a viral disease transmitted by the Aedes aegypti mosquito, which can also transmit other arboviruses such as Zika, chikungunya and yellow fever. According to the World Health Organization, dengue is endemic in more than 100 countries, with about 40% of the world’s population at risk of infection. In 2020, there will be an estimated 100 million cases of dengue worldwide, resulting in 22,000 deaths.
Brazil is one of the countries most affected by dengue, with more than 1.5 million cases and 800 deaths reported in 2020. The country faces several challenges in controlling the disease, including high population mobility, urbanisation of rural areas, lack of sanitation and waste management, and climate change, which favours the expansion of the mosquito’s habitat.
To address this public health problem, the Brazilian Ministry of Health has launched a series of initiatives to prevent and respond to dengue outbreaks. One of these is the creation of the Emergency Operations Centre against Dengue and other Arboviruses (COE Dengue), which started its activities on Saturday 3 February 2024.
The COE Dengue is a space for collecting and analysing data on the national epidemiological scenario, producing daily reports on the dengue situation, providing guidance to states and municipalities and making decisions on the best strategies to combat the disease. The centre is made up of representatives from different sectors of the Ministry of Health, as well as other institutions such as the National Health Surveillance Agency, the Oswaldo Cruz Foundation (Fiocruz), the Pan American Health Organisation (PAHO) and state and municipal health councils.
The aim of the COE Dengue is to allow greater agility in monitoring and analysing the dengue scenario and to face the progression of the disease in the country. The centre also aims to prevent the disease from becoming a national emergency, beyond the states that have already declared it. The Minister of Health, Nísia Trindade, explained that the creation of such a centre is done whenever there is a national emergency or when there is an attempt to avoid such a situation. “This is what we are doing today,” she said.
In addition to the monitoring centre, the Ministry of Health has also set aside an additional 10% of resources for each state and municipality in the event of an emergency. There is also a provision of R$ 140 million for actions related to the care of the population.
The Minister of Health also stressed the importance of the joint action of the Ministry of Health, mayors, governors and society as a whole in the fight against dengue. She reminded that the focus of the managers should be on the orientation of the population and the prevention of the disease by eliminating the breeding places of the mosquitoes. The recommendation is not to give the Aedes aegypti a place to breed. Containers with stagnant water, whether very large or very small, can be breeding grounds for mosquito larvae. It is essential that each citizen is aware of the risks and constantly inspects his or her surroundings.
Another initiative of the Ministry of Health is to support the development and production of dengue vaccines in the country. Brazil is the first country to offer dengue vaccines in the public health system. The SUS acquired the available production of the Qdenga vaccine, produced by the Japanese laboratory Takeda, and it was the largest acquisition of the vaccine in the world. With the support of the Ministry of Health, Fiocruz will join efforts to increase the production of the Takeda vaccine, which will be offered to the population in two doses. The Ministry of Health has purchased 6.5 million doses of the vaccine for 2024 and 9 million for 2025.
The Ministry of Health is also working with the Butantan Institute, which is developing the Butantan DV vaccine, which is in the final stages of clinical trials. The meeting between the Minister of Health, the Director of the Butantan Institute, Esper Kallás, and the President of Fiocruz, Mario Moreira, aimed to unite and coordinate efforts to expand access to dengue vaccines to the entire population.
These are some of the measures the Brazilian government is taking to address the challenge of dengue and other arboviruses, which pose a serious threat to the health and well-being of millions of people. By investing in prevention, surveillance, response and research, Brazil hopes to reduce the burden of these diseases and improve the quality of life of its people.