Insights and Analysis

Dengue’s Rise in Asia: Battling a Deadly Side Effect of Climate Change

December 16, 2009

By John J. Brandon

While emerging diseases like H1N1, also known as swine flu, dominate headlines, dengue fever is quietly exacting a far more devastating toll on public health than the swine flu. While there have been more than 525,000 swine flu cases worldwide in 2009 leading to 9,800 deaths, the World Health Organization (WHO) estimates 50 million people were infected by the dengue virus in 2009, and approximately 25,000 of them died.

According to a recent United Nations report on climate change, just a half-degree rise in temperature centigrade can lead to a 30 to 100 percent increase in mosquitoes and therefore, the prevalence of dengue fever. The Lowy Institute in Australia reports that by 2085, 52 percent of the world’s population – about 5.2 billion people – will be living in areas at risk of dengue due to greater population mobility and increased urbanization.

With President Obama and other world leaders in Copenhagen this week for the climate change conference, they should pay ample attention to the connection between environmental changes and human health.

Besides causing severe fever, dengue’s symptoms include headaches, nausea, skin rashes, chills, and muscle and joint pains. In its worst form, dengue leads to death. In 1979, when travelling in Southeast Asia, I contracted dengue fever. For more than a week I felt like my body was on fire, with headaches so severe I felt as if someone put my head on an anvil and was wailing away with a sledgehammer. There were times I was delirious, and afraid I might die. They did not nickname dengue “break-bone fever” for nothing. Unlike malaria, there are no prophylactic drugs to prevent infection.

In 2008, 3,255 people died of dengue fever across Southeast Asia. In 2009, more than 600 people have already died from dengue in Indonesia alone, compared to three people from swine flu. The number of fatalities from dengue fever in the region is almost triple what it was in 2003. Yet, dengue fever is almost entirely neglected by Asia’s public health systems. Efforts to prevent and control dengue have been constrained due to lack of sustained political commitment, inadequate resources, and lack of a coordinated effort.

Dengue fever is spread because of conditions that exist in Asia’s fastest growing cities with tropical climates – such as Bangkok, Jakarta, and Manila – where many residents live in substandard housing with poor sanitation. Open barrels, used tires, and trash dumps act as ideal breeding grounds for the mosquitoes that pass along the virus.

Many Asian governments have done little to mitigate dengue fever. Part of the problem is that dengue is not caused by a single virus but by four distinct viral strains. If any reliable vaccine is to be developed, it must provide protection from all four strains. Given that dengue fever mostly affects poor countries, a vaccine is not likely to be a major money-maker for international drug companies, making it likely that public funds and foreign assistance will be necessary to get a vaccine to the people who need it.

Regional institutions like the Association of Southeast Asian Nations (ASEAN) and the ASEAN Regional Forum (ARF) should work together, as ASEAN did in 2003 in addressing the SARS crisis, to develop a surveillance system that can provide early warning of dengue epidemics. Failure to do so will cause thousands of people to suffer and die needlessly each year.

John J. Brandon is The Asia Foundation’s Director of International Relations Programs in Washington, D.C. He can be reached at [email protected].


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InAsia is a bi-weekly in-depth, in-country resource for readers who want to stay abreast of significant events and issues shaping Asia’s development, hosted by The Asia Foundation. Drawing on the first-hand insight of renowned experts, InAsia delivers concentrated analysis on issues affecting each region of Asia, as well as Foundation-produced reports and polls.

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