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A sustainable, integrated approach
to the prevention, control and
elimination of vector-borne
diseases
Proposal for collaborative action
Dr Yvan Hutin, Director, Division of Communicable Disease Control
Distribution of long-lasting
insecticidal nets in Yemen
The 2022 floods
emergency in Pakistan:
A major malaria outbreak
with long lasting
consequences
Vector-borne diseases are expanding over time in
the Eastern Mediterranean Region, causing
morbidity, mortality and economic loss
Higher endemic burden, more outbreaks
Causes: Insufficient programme investment, climate change,
conflict, displacement, migration and urbanization
Three main groups of vector-borne diseases
Anopheles
(malaria)
The silent killer  majority of the
burden
• More rural
• More mortality
• Programme
platform
Aedes
(yellow fever, dengue, chikungunya,
Zika virus disease outbreaks)
• More urban
• More morbidity and
economic impact
(e.g. tourism)
• Emergency
response
Others
• Leishmaniasis
• Zoonoses, some of
them highly lethal
• Onchocerciasis
• Lymphatic filariasis
- Crimean-Congo
haemorrhagic fever
- Rift Valley fever
- Zoonotic leishmaniasis
- Schistosomiasis
Should we address these
together or separately?
1369 million healthy life years lost to vector-borne
diseases in the Eastern Mediterranean Region in 2019
Onchocerciasis Lymphatic filariasis Yellow fever
Trachoma Dengue Schistosomiasis
Leishmaniasis Malaria
Severe visceral
leishmaniasis in a child,
Khartoum, Sudan
Bleeding manifestations
of Crimean-Congo
haemorrhagic fever
The malaria situation is unstable
because of insufficient
programme response, climate
change and biological threats
Malaria-free countries
High-burden countries targeting control
Focal transmission targeting elimination
Aedes leads to outbreaks of dengue, chikungunya
and yellow fever
Malaria-free countries
High-burden countries targeting control
Focal transmission targeting elimination
D
D
D
D
`
C
,
Y
D
C
C
Presence of Aedes aegypti
C Chikungunya
D Dengue outbreaks
Y Yellow fever
D
Presence of Aedes albopictus
?
Vector-borne diseases are on the increase
0
50,000
100,000
150,000
200,000
250,000
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Number
of
cases
reported
Year
Reported cases of cutaneous leishmaniasis,
Eastern Mediterranean Region, 19982022
Reported number of outbreaks of dengue,
Eastern Mediterranean Region,
2009April 2023
0
1
2
3
4
5
6
7
2017 2018 2019 2020 2021 2022 2023
Number
of
reported
outbreaks
April 2023
We know how
to handle this,
we just
need to join
forces
Strong programme
base for malaria?
 Expand to all
vector-borne diseases
Strong emergency
response capacity?
 Consolidate to address
all threats
Malaria programme
and dengue response?
 Optimize response with a
single vector-borne disease
programmatic approach
We shaped the strategy from the challenges we face
Prevention, detection, diagnosis, management
Vectors and environment
 Eco-epidemiology,
biological threats
Integrated vector surveillance and control
Coordinated programmatic approach
Cadre
Integrated disease surveillance
Resources insufficient?
Let’s consolidate all investments around a vision!
Context
 Emergencies, migrations,
fragmentations
Capacities
 Entomology, pesticide
management
Information gap
 Weak surveillance
Building blocks of an integrated programmatic approach:
Cost-effectiveness – Sustainability – Resilience
Vector
surveillance
and control
Diagnosis Surveillance
Case
management
Outbreak
preparedness
and response
Monitoring
and
evaluation
Multisectoral
coordination:
engaging
communities,
agriculture
sector
In 2023, Pakistan is
moving forward with
integrated vector
surveillance and
control on a pilot
basis with WHO
support
How can we build on the experience of malaria
programmes, the response to COVID-19, and emerging
diseases, with contributions from all relevant WHO
departments?
We want to hear from you:
What is the best way to ensure a country-owned, integrated
programmatic approach to malaria and other vector-borne diseases?
How can WHO help you reach this goal?

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  • 1. A sustainable, integrated approach to the prevention, control and elimination of vector-borne diseases Proposal for collaborative action Dr Yvan Hutin, Director, Division of Communicable Disease Control Distribution of long-lasting insecticidal nets in Yemen
  • 2. The 2022 floods emergency in Pakistan: A major malaria outbreak with long lasting consequences
  • 3. Vector-borne diseases are expanding over time in the Eastern Mediterranean Region, causing morbidity, mortality and economic loss Higher endemic burden, more outbreaks Causes: Insufficient programme investment, climate change, conflict, displacement, migration and urbanization
  • 4. Three main groups of vector-borne diseases Anopheles (malaria) The silent killer  majority of the burden • More rural • More mortality • Programme platform Aedes (yellow fever, dengue, chikungunya, Zika virus disease outbreaks) • More urban • More morbidity and economic impact (e.g. tourism) • Emergency response Others • Leishmaniasis • Zoonoses, some of them highly lethal • Onchocerciasis • Lymphatic filariasis - Crimean-Congo haemorrhagic fever - Rift Valley fever - Zoonotic leishmaniasis - Schistosomiasis Should we address these together or separately?
  • 5. 1369 million healthy life years lost to vector-borne diseases in the Eastern Mediterranean Region in 2019 Onchocerciasis Lymphatic filariasis Yellow fever Trachoma Dengue Schistosomiasis Leishmaniasis Malaria Severe visceral leishmaniasis in a child, Khartoum, Sudan Bleeding manifestations of Crimean-Congo haemorrhagic fever
  • 6. The malaria situation is unstable because of insufficient programme response, climate change and biological threats Malaria-free countries High-burden countries targeting control Focal transmission targeting elimination
  • 7. Aedes leads to outbreaks of dengue, chikungunya and yellow fever Malaria-free countries High-burden countries targeting control Focal transmission targeting elimination D D D D ` C , Y D C C Presence of Aedes aegypti C Chikungunya D Dengue outbreaks Y Yellow fever D Presence of Aedes albopictus ?
  • 8. Vector-borne diseases are on the increase 0 50,000 100,000 150,000 200,000 250,000 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 Number of cases reported Year Reported cases of cutaneous leishmaniasis, Eastern Mediterranean Region, 19982022 Reported number of outbreaks of dengue, Eastern Mediterranean Region, 2009April 2023 0 1 2 3 4 5 6 7 2017 2018 2019 2020 2021 2022 2023 Number of reported outbreaks April 2023
  • 9. We know how to handle this, we just need to join forces Strong programme base for malaria?  Expand to all vector-borne diseases Strong emergency response capacity?  Consolidate to address all threats Malaria programme and dengue response?  Optimize response with a single vector-borne disease programmatic approach
  • 10. We shaped the strategy from the challenges we face Prevention, detection, diagnosis, management Vectors and environment  Eco-epidemiology, biological threats Integrated vector surveillance and control Coordinated programmatic approach Cadre Integrated disease surveillance Resources insufficient? Let’s consolidate all investments around a vision! Context  Emergencies, migrations, fragmentations Capacities  Entomology, pesticide management Information gap  Weak surveillance
  • 11. Building blocks of an integrated programmatic approach: Cost-effectiveness – Sustainability – Resilience Vector surveillance and control Diagnosis Surveillance Case management Outbreak preparedness and response Monitoring and evaluation Multisectoral coordination: engaging communities, agriculture sector
  • 12. In 2023, Pakistan is moving forward with integrated vector surveillance and control on a pilot basis with WHO support
  • 13. How can we build on the experience of malaria programmes, the response to COVID-19, and emerging diseases, with contributions from all relevant WHO departments? We want to hear from you: What is the best way to ensure a country-owned, integrated programmatic approach to malaria and other vector-borne diseases? How can WHO help you reach this goal?