Successes and failures in dengue control: global experience

Despite the admirable achievement of the control and near eradication of Aedes aegypti in the Western hemisphere in the mid-twentieth century, today this species is more abundant and widespread than at any time in human history. As a result, dengue viruses have spread to be among the most common pathogens on earth. This paper reviews the history of the success and then the failure to control Aedes aegypti. Two crucial failures contributed to the dismal story of dengue control: (1) no major educational institution has ever committed itself to solve the problem; and (2) there are no outraged and vocal citizen groups. At least 12 sectors of society have some interest in or responsibility for the control of dengue: national health, city health, environment, urban planning, justice, education, science and technology, the media, private sector and people themselves. The current roles of these sectors in the control of dengue are given. This is followed by a description of the more active roles that might be adopted by each of these sectors. Finally, advocacy methods are described for use by physicians, public health workers and scientists who face the problem of dengue on a daily basis.