Next Generation Dengue Vaccine, other Solutions Presented
Dengue continues to pose a significant public health challenge in the Philippines. However, it is comforting to note that the field of medical science is progressing and actively exploring innovative approaches, including the development of new vaccines and other creative solutions to directly confront the dengue crisis.
On Wednesday, September 27, the first-ever Dengue Forum, themed "Addressing the Mosquito in the Room," had the primary goal of intensifying discussions regarding dengue as a prominent public health issue in the Philippines. This event was orchestrated by the RiseAboveNow Business Consulting Group (RAN-BCG) and received backing from both the Embassy of Japan in the Philippines and the Department of Health (DOH).
Between January 1 and September 9 of this year, the nation has recorded 125,975 cases of dengue, a significantly lower number compared to the past five years. Since mid-June 2023, an average of 5,000 cases per week has been reported, as stated by the Department of Health (DOH) in the Philippines. Despite the apparent stabilization of dengue cases, the DOH remains vigilant and does not rule out the potential for an increase in cases during the upcoming rainy season.
In the recent Dengue Forum titled "Addressing the Mosquito in the Room," the current impact of dengue was thoroughly discussed. The forum brought together a panel of experts representing various fields from both government agencies with relevance to the issue and the private sector. Its objectives included raising awareness about the ongoing Dengue Crisis, assessing the current extent of the problem, devising a comprehensive multi-sectoral strategy, and notably, exploring recent global developments in innovative solutions that have the potential to effectively combat the dengue crisis. Furthermore, this dengue forum served as a valuable opportunity to establish a robust platform for collaboration among multiple stakeholders in addressing the dengue situation in the country.
In an official statement, Secretary of the Department of Health (DOH), Dr. Teodoro J. Herbosa, underscored the critical nature of the event and emphasized the necessity of a comprehensive approach. He stated, “This event carries profound significance as it highlights the importance of a Philippine Collaborative response framework. Dengue is a self-limiting disease, there is currently no definitive therapy or regimen available.” With the successful mitigation of the COVID-19 threat, dengue has now emerged as one of the most prominent health concerns in tropical countries like the Philippines.
Dr. Jose Rene de Grano, MHA, who serves as the president of the Private Hospitals Association of the Philippines, and pediatrician Dr. Maria Fatima Gualberto, representing Otsuka Solar Phils. Inc. of Japan, jointly emphasized that dengue has become one of the primary reasons for hospitalization in the period following the COVID-19 pandemic. Furthermore, Dr. Kim Patrick Tejano from the DOH Disease Prevention and Control Bureau highlighted that dengue has ranked as the second most costly health condition in terms of PhilHealth claims across the nation in the past year.
Additionally, Ms. Angelica Garcia from the DOH Epidemiology Bureau presented a concerning statistic: 56% of all dengue-related fatalities involve children aged 9 years or younger. Moreover, she pointed out that a staggering 70% of all reported dengue cases affect individuals aged 19 years or younger.
Representatives from Local Government Units located in areas with relatively low dengue incidence, such as Pasig, Caloocan, Quezon City, and Baguio, shared their successful strategies in the realm of vector control, particularly focusing on the strict adherence to the Five S method for dengue control. These practices revolved around the following principles:
Search and destroy: A proactive approach to locating and eliminating mosquito breeding sites.
Self-protect: Encouraging individuals to take personal measures to safeguard themselves from mosquito bites.
Seek consultation: Promptly seeking medical advice and treatment in case of dengue symptoms.
Support fogging: Employing fogging and other mosquito control methods in a targeted and effective manner.
Sustained Hydration: Emphasizing the importance of maintaining proper hydration, particularly during dengue infections.
These local best practices aimed at not only preventing dengue but also ensuring effective responses in the event of outbreaks.
New hope, a LOT of new hope.
The most encouraging news, however, came from the medical experts at the event, who revealed that new tools have emerged in the battle against dengue. Dr. Rontgene Solante, a consultant to the Department of Health (DOH) and a distinguished authority in infectious diseases, emphasized the importance of rigorous vector control but also cautioned against relying solely on this approach, noting that it could potentially hinder the development of herd immunity.
Dr. Solante then introduced the promising development of second-generation dengue vaccines. One of these vaccines has already received licensing for use in over 30 countries, including neighboring ASEAN nations like Indonesia and, more recently, Thailand.
These new-generation vaccines represent a significant advancement over their predecessors. They can be safely administered to individuals, whether or not they have previously experienced dengue infection. The efficacy of these vaccines is notably superior to that of first-generation vaccines. Dr. Solante highlighted that the TAK003 vaccine, which has obtained licenses in over 30 countries, demonstrates an impressive 80.2% effectiveness in preventing dengue infection, in contrast to the 56% efficacy of the first-generation vaccine. Furthermore, the TAK003 vaccine exhibits a remarkable 95.4% efficacy in preventing severe dengue, surpassing the 91% efficacy of the initial generation vaccine.
Dr. Solante explained that the key to the superior performance of second-generation vaccines lies in their foundation. These vaccines are constructed using a dengue virus backbone, which differs from the first-generation vaccines that were based on a Yellow Fever backbone. This fundamental distinction is also the reason why second-generation vaccines are effective for individuals who have never been exposed to dengue, as they are designed to directly combat the dengue virus.
Even with the encouraging potential of an effective vaccine, Dr. Solante reiterated Secretary Herbosa's viewpoint, emphasizing that a multi-faceted approach is essential. He stated, "Vector control, environmental management, patient education, awareness, and advancements in clinical management are all components of what we term an integrated approach, with vaccination being a crucial part of it. This is what we refer to as a comprehensive strategy, where vaccination and vector control work hand in hand." This comprehensive strategy acknowledges that both vaccination and various preventive measures are indispensable in the fight against dengue.
TAK003 is manufactured by global, research and development-driven pharmaceutical company Takeda. Takeda was represented at the forum along with three other Japanese firms and no less than Minister for Economic Affairs at the Embassy of Japan in the Philippines, Mr. Nihei Daisuke who affirmed Japan’s commitment to help ease the global burden of dengue: “We also consider dengue as an international concern, and we are one with the Philippines in your fight against this disease.”
The TAK003 vaccine has received a significant endorsement as it was recently recommended by the World Health Organization's Strategic Advisory Group of Experts (SAGE) for deployment in regions characterized by a substantial dengue disease burden and high transmission rates. This recommendation aims to maximize the public health impact of the vaccine. Additionally, SAGE stressed the importance of introducing the vaccine alongside a well-planned communication strategy and active community engagement to ensure its effective implementation.
In addition to new vaccines, Dr. Anna Lisa Ong-Lim, the Chief of the Division of Infectious and Tropical Disease at the Philippine General Hospital, revealed that there are noteworthy advancements in the development of antiviral medications. These antivirals have the potential to offer immunity and treatment for individuals already infected with the dengue virus. During her presentation, Dr. Ong-Lim not only explained how these antivirals work but also provided insights into the stages of clinical trials where they have demonstrated promise.
Dr. Ong-Lim not only highlighted the potential of new developments but also discussed the effectiveness of straightforward yet ingenious strategies that have demonstrated success on a global scale. One example she mentioned is the use of mosquito nets to cover entire small villages. While emphasizing the significance of vaccines, she also stressed how much more effective these efforts can be when combined with other tactics. She stated, “Of course, we know that vaccines are known to be the most efficient approach to be able to target big numbers in these kinds of conditions, but when vaccines are complemented by therapeutic agents, you can even [have] better control.” This underscores the synergy that can result from a comprehensive approach to dengue prevention and treatment.
With these promising new developments, there is hope that dengue can be significantly reduced to the point where it becomes a minor concern. However, achieving widespread dengue vaccination will depend on raising awareness and education among all Filipinos. It is crucial that people become informed about this disease and advocate for the use of all available means to bring an end to this crisis. Public awareness and demand for comprehensive dengue prevention and treatment strategies will play a vital role in effectively combating this health issue.
