This article was originally published on the Dengue Vaccine Initiative's blog and is cross-posted here with permission. IVAC is a member of the Dengue Vaccine Initiative. (DVI)
Earlier this year, DVI convened the Americas Dengue Prevention Board along with scientists, global health experts, mathematical modelers and representatives of dengue vaccine manufacturers to discuss updates in dengue vaccines and vaccine introduction. Held in Bogota at the Colombian National Institute of Health (Institituto Nacional de Salud – INS), the meeting was instrumental given the new available clinical trial data, particularly the results of the first Phase 3 trials ever completed for a dengue vaccine candidate. These results demonstrated that a safe and effective dengue vaccine is feasible.
A mosquito that costs over $2 billion
Dengue, caused by a small mosquito with black and white striped legs, is the most widespread vector-borne disease in the Americas. In 2013, cases and deaths nearly doubled those of previous years in the region. The southern cone reported the highest incidence rate of cases, but the Andean region reported the highest number of severe cases. The burden of dengue in the Americas has been estimated at more than $2 billion dollars, from hospitalization costs to loss of productivity, representing a significant threat to the wellbeing of the region.
A safe and effective vaccine can help reduce this threat. While the decision to introduce a dengue vaccine can only be driven at the country level, such decisions must be based on sound evidence. DVI Dengue Prevention Board Meetings seek to share and update existing dengue knowledge and identify gaps to ensure countries have scientific, objective data to make informed public health decisions proactively, before a vaccine becomes available.
An open forum to share dengue knowledge –-and its gaps
With this objective in mind, the meeting offered an open forum where participants revisited the minimum requirements for successfully launching a dengue vaccination program among other crucial dengue topics.
On the first day, they reviewed the status of dengue vaccine development with representatives of the manufacturers of the five vaccines in clinical trial (Butantan/NIH, GSK/Fiocruz/Walter Reed, Merck, Sanofi Pasteur and Takeda). They also discussed the applications of mathematical modeling for predicting the impacts of dengue vaccination.
On the second day, country representatives presented the current dengue situation in their homeland and perspectives on dengue vaccine introduction and use.
Finally, the meeting broke into groups to assess considerations for vaccine introduction. The Board then met separately to draw conclusions. The meeting ended with the closing remarks of the Colombian Ministry of Health, who highlighted the spread of dengue and the urgent need to stop it.
The Board noted the critical importance of linked disease surveillance and vaccination registries to monitor coverage and vaccine effectiveness, as well as monitoring for vaccine safety. They also urged the standardization of age groups and case definitions of dengue disease across countries in the region to enable comparisons. They called for further analyses to understand how a limited supply of vaccine might best be utilized in the first year(s) of vaccine introduction. They affirmed the importance of the Pan-American Health Organization (PAHO) for supporting vaccine introductions, particularly through activities such as issuing recommendations for laboratory-based disease surveillance in the region, with an aim of standardizing the diagnostic tests.
In 2007, PDVI (Pediatric Dengue Vaccine Initiative—DVI’s precursor) established two regional Dengue Prevention Boards (DPBs) — one for Asia and one for the Americas. Members of the boards include medical and public health experts, opinion leaders and policy makers from countries in their respective regions. They meet once a year to advise on dengue surveillance, diagnostics, vaccine introduction and communications.
All reports on DPB meetings are published in the DVI website to inform dengue and global health stakeholders.