Rise of Dengue Cases Cause for Concern

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Experts underscore strategies and new discoveries in protecting our children

In the face of the lethal threat that Dengue poses, especially for children, the nation must take collective action and utilize new innovations against the potentially fatal disease. That was the core lesson the country’s foremost public health authorities emphasized at a recent discussion entitled “A Dengue Dialogue: Protecting our Children from the Epidemic” hosted by the Vaccine Solidarity Movement (VSM).

“My oldest daughter had it 2 times! It was very scary, and I would not want to go through any of that again — but the reality is we are all at risk. Wala pong pinipili ang dengue, bata o matanda, mayaman o mahirap. [dengue can hit anyone, old or young, rich or poor] Ang nakakatakot sa dengue pag akala mo gumaling ang lagnat okay na [what’s scary is, you think it’s better because the fever breaks] BUT that is when it can get fatal. Wag hintayin mawala ang lagnat [don’t wait till the fever breaks], seek medical attention & manage right away.” the event's moderator, broadcaster Niña Corpuz-Rodriguez, shared her personal experience. Like Rodriguez, numerous parents are anxiously seeking more effective solutions to safeguard their children against this debilitating disease.

Signs of the times

In 2023 a record year for dengue globally, unusually dryly “slow” year for the Philippines for dengue, we ranked third among countries with the highest dengue cases.[1] Looking back at previous years' data, it was discovered that in 2019, which was considered a record year for the Philippines, there were 371,717 recorded dengue cases, resulting in 1,407 deaths.[2] Approximately half of these dengue-related deaths occurred in children between the ages 5 and 9.[3] If the Philippines not been spared from the record year 2023 due to an unusually dry rainy season, which spared the country from a more severe outbreak, it is estimated that over 1,000 children could have lost their lives to dengue in the same year.

According to Department of Health (DOH) Undersecretary of Health for Public Health Services and Chief Information Officer Eric Tayag, there is a possibility of an earlier rise in cases due to El Niño. However, the severity of the dengue outbreaks this year will depend on the behavior of communities and the effectiveness of control measures implemented.

So, now there is an urgent need to utilize all available weapons in the existing anti-dengue arsenal in our war against dengue. Failure to do so could result in a devastating outcome, with well over 1,000 children losing their lives when dengue inevitably hits us hard again.

A whole-of-nation approach for our children

The experts on the panel emphasized the importance of collective involvement in combating this disease VSM Co-Founder Amor Maclang, speaking at the event, urged the entire nation to actively engage in the fight against Dengue, “Public health issues can only be taken on if the private sector, the government, the whole of society takes on the issue.”

Dr. Benny Atienza, Vice President of the Philippine Federation of all Professional Associations and Immediate Past President of the Philippine Medical Association, cited an example of a collaborative effort involving children and the adults in their lives. He mentioned the development of catchy songs designed to creatively educate children about the disease, enabling them to recognize and effectively communicate symptoms to guardians and medical professionals.

During the event, Dr. Vicente Belizario Jr., a respected Professor and Former Dean of the College of Public Health at the University of the Philippines Manila, as well as the President of the Philippine Academic Consortium for Public Health, emphasized the crucial role of media and journalists in raising dengue awareness among parents, guardians, and even teachers. He highlighted the significance of education in empowering individuals with knowledge about the disease, its symptoms, prevention methods, and the importance of early detection. Dr. Belizario recognized the media's power to reach a wide audience through television, radio, newspapers, and online platforms, enabling the dissemination of accurate and up-to-date information about dengue.. “Media, we appeal to you to raise awareness sapagkat may kanya-kanya po tayong role para maka-iwas sa dengue [because we each have our own role to fulfill in Dengue prevention]”, said Dr. Belizario Jr., called out.

A game-changing new weapon

Dr. Nina Gloriani, former Head of the Vaccine Expert Panel of the Department of Science and Technology (DOST), encourages the public to “move with the times” and take advantage of new discoveries such as next-generation vaccines. One of the next-generation vaccines available on the market today is TAK-003, the only next-generation vaccine that has been licensed for use in more than 30 countries: the European Union (EU), the United Kingdom, Argentina and Countries with dengue epidemiological situations similar to the Philippines such as Indonesia, Brazil and more recently Thailand.

The TAK-003 is safe to use for everyone, even those who have not previously had Dengue. The vaccine was engineered on a Dengue backbone, unlike the first dengue vaccine in the market. TAK-003 can create immune responses at different levels to all four strains of dengue virus[4] helping to prevent disease and reduce the likelihood of hospitalization in people with dengue fever. The World Health Organization’s (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization recommends a well-designed communication strategy and community engagement along with the vaccine.[5]

Gloriani's words resonated with a powerful sense of hope and optimism as she discussed the implementation of vaccines “Hopefully maidagdag natin yung [we can add] vaccination. Meron nang mga pagbabago. [There are new developments.] Nakita nyo kung paano natin nagamit ang mga bagong technology [You’ve seen how new technologies were utilized] for COVID and we have a lot of lessons learned from that”, she said. Her message left no room for doubt, a strategic use of vaccines can pave the way for a better future in our fight against dengue – especially in protecting our children.

Undersecretary Tayag while emphasizing the importance of a meticulous evaluation process, expressed a willingness to consider the introduction of a new vaccine. His statement reflects a balanced approach, acknowledging the need for thorough assessment to ensure the safety and efficacy of any potential vaccine. He said, “So ninilaw lang po namin na nananatiling bukas ang Department of Health. Subalit, katulad ng ginawa namin sa COVID, ito ay may mga pag-aaral na dapat gawin at ito ay aming tinitingnang mabuti sapagkat may responsibilidad kami na kung ito man ay irere-introduce natin, ang aming prinsipyo po ay “first do no harm”. [We want to make it clear that the Department of Health remains open. But just like what we did in the COVID-19 situation, this requires a careful study, and we are looking closely into it because if we will re-introduce it, we have a responsibility to follow our ‘first do no harm’ principle.”

With an extraordinary triumph over COVID-19 vaccine misinformation, the Philippines has emerged as a global frontrunner, ranking fourth in single-day vaccine uptake and administering a staggering 2.7 million vaccinations in a single day. Dr. Atienza shared this remarkable achievement at the roundtable panel discussion, underscoring the nation's unwavering commitment to public health. Buoyed by this success, the Vaccine Solidarity Movement (VSM) is now spearheading efforts to combat dengue and other vaccine-preventable diseases, further solidifying their dedication to safeguarding the well-being of the public especially for the children.

"We have to turn up the same fervor that we turned on during the COVID pandemic and we have to right now rally behind the objective of the DOH. 95% coverage," echoed Maclang.

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1 https://reliefweb.int/report/world/epidemiological-alert-sustained-circulation-dengue-region-americas-5-december-2023#:~:text=The%20year%202023%20is%20the,and%201%2C823%20deaths%20(1.2).

2https://reliefweb.int/report/philippines/philippines-situation-report-9-dengue-outbreak-5-november-2019#:~:text=371%2C717%20dengue%20cases%2C%20including%201%2C407,same%20epidemiological%20week%20in%202018.

3https://reliefweb.int/report/philippines/nearly-half-all-dengue-deaths-philippines-are-children-under-nine-years-old

[4] https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(23)00522-3/fulltext

[5] https://www.news-medical.net/news/20231009/WHO-experts-recommend-the-use-of-Takedas-dengue-vaccine-QDENGA.aspx

Health Experts Raise Alarm on Dengue Crisis

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 Next Generation Dengue Vaccine, other Solutions Presented

Dengue remains to be a major public health problem in the Philippines. But it is reassuring to know that medical science has continued to develop and is working on real solutions, such as new vaccines and other novel and ingenious solutions that address the dengue crisis head on.

Affirming that the full might of Japan, one of the healthiest nations in the world, is behind the Philippines in its fight against dengue: Minister Nihei Daisuke, Minister for Economic Affairs, Embassy of Japan in the Philippines.

The inaugural Dengue Forum titled “Addressing the Mosquito in the Room” held last Wednesday, 27 September, aimed to amplify the conversation on dengue as a public health concern in the Philippines. The event was organized by RiseAboveNow Business Consulting Group (RAN-BCG) and was supported by the Embassy of Japan in the Philippines and the Department of Health (DOH).

Between 1 January and 9 September of this year, 125,975 dengue cases were reported across the nation, so far lower compared to cases in the last five years.  Since mid-June 2023, 5,000 cases have been registered on an average every week, according to the Department of Health (DOH), Philippines.^[1] Despite the plateauing dengue cases, the DOH is not shutting down the possibility of an uptick in cases during the coming the rainy season.

The present impact of dengue was described in the recent dengue forum "Addressing the Mosquito in the Room": The forum gathered a panel of experts from various relevant fields from both relevant government agencies, as well as from the private sector. It aimed to raise the alarm on the already ongoing Dengue Crisis, assess the extent of the burden at this time, map out a multi-sectoral strategy, but perhaps most importantly, to discuss new developments globally on newly introduced solutions that can make a real impact in ending the dengue crisis. This dengue forum was also an opportunity to establish a robust platform for multi-stakeholder collaboration in addressing the dengue situation in the country.

In an official statement, Secretary of the Department of Health (DOH) Teodoro J. Herbosa, MD, emphasized the urgency of the event, and the importance of a holistic approach: “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,” he stressed. With the COVID-19 threat now effectively mitigated, dengue now looms as the one of the most prevalent health concerns in tropical countries such as the Philippines.

Dr. Jose Rene de Grano, MHA, president of the Private Hospitals Association of the Philippines, and pediatrician Dr. Maria Fatima Gualberto of Otsuka Solar Phils. Inc. of Japan shared that dengue was among the leading causes of hospitalization in the post COVID-19 era. While Dr. Kim Patrick Tejano of DOH Disease Prevention and Control Bureau pointed out that dengue was the second biggest health condition in terms of cost for PhilHealth claims nationwide in the last year.

The DOH was represented by Ms. Angelica Garcia Supervising Health Program Officer DOH Epidemiology Bureau (Center), who gave a thorough situation report on dengue in the Philippines for the last 3 years. She is flanked by Lo-Anne Villanueva, Country Manager of Takeda Pharmaceuticals (Right) and Ranielle Mendoza -Founding Partner of Rise Above Now (Left).

Meanwhile Ms. Angelica Garcia of the DOH Epidemiology Bureau, shared the alarming truth, that statistically, 56% of all dengue fatalities are children 9 years old or younger. Furthermore, 70% of all dengue cases are people 19 years old or younger.

Representatives from Local Government Units where dengue incidence was relatively low namely Pasig, Caloocan, Quezon City and Baguio shared their best practices in the area of vector control, or eradication of mosquitoes, emphasizing adherence to the Five S method of controlling dengue:  

Search and destroy

Self-protect 

Seek consultation

Support fogging

Sustained Hydration

 

The fact that Dengue is among the leading causes of hospitalization in the Philippines was pointed out by Dr. Jose Rene de Grano, MHA, President Private Hospitals Association of the Philippines, Inc. (Center). He is flanked by Lo-Anne Villanueva, Country Manager of Takeda Pharmaceuticals (Right) and Ranielle Mendoza -Founding Partner of Rise Above Now (Left).

New hope, a LOT of new hope.

However, the most promising news came from the medical experts on hand, who shared that there are in fact new weapons that are available in the war against dengue. Consultant to the DOH and eminent infectious disease authority, Dr. Rontgene Solante fully acknowledged the need for stringent vector control, but he cautioned: “If you focus only on vector control, there is a possibility that it can also reduce herd immunity.” Dr. Solante then shared that there are in fact second-generation dengue vaccines, one that is actually already licensed for use in over 30 countries, including ASEAN neighbors Indonesia and more recently Thailand.

This  vaccine are far more advanced than the previous generation. They can be administered safely to people whether or not they have previously had dengue. Numbers are also significantly better than 1st gen vaccine. Solante shared that the TAK003 vaccine already licensed in over 30 countries are 80.2% effective at preventing dengue infection, compared to just 56% for first gen vaccine, it is also 95.4% effective at preventing severe dengue, whereas first generation vaccine had only 91% efficacy.

Dr. Solante shared that the reason behind the superiority of 2nd generation vaccines was that they were engineered on a dengue virus backbone, whereas the 1st generation was built on a Yellow Fever backbone. This is also the reason why 2nd gen vaccines are effective even for those who have never had dengue.

Despite the promise of an effective vaccine, Dr. Solante echoed Secretary Herbosa’s opinion: “Vector control, environmental control, patient education, awareness, even updates in the clinical management are all part of what we call an integrated approach and a vital part of this will be vaccination. So, this is what we call a comprehensive strategy. You have vaccination, as well as vector control.”

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.”

TAK003 vaccine was also recently recommended by the World Health Organization’s Strategic Advisory Group of Experts (SAGE) for introduction in settings with high dengue disease burden and high transmission intensity to maximize impact to public health and that the vaccine introduction should be accompanied by a well-designed communication strategy and community engagement.^[2]

New vaccines are not the only new development, Dr. Anna Lisa Ong-Lim, Chief of the Division of Infectious and Tropical Disease at the Philippine General Hospital shared that there is in fact promising news in the area of developing antivirals that could both provide immunity and cure already infected patients. In her presentation, Dr. Ong-Lim shared both the action of the antivirals in development, as well as what stage of trials they have already shown promise in.

While sharing the promise of new developments, Dr. Ong-Lim also talked about simple yet ingenious best practices that have worked worldwide, such as mosquito nets that are used to cover entire small villages. She did reiterate the importance of vaccine, but also pointed out how much more effective these would be if combined with other tactics: “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.”

Ultimately with these new developments, it will be possible to bring dengue numbers down to insignificant levels. To make dengue vaccination widespread though, will require that every Filipino learn more about this disease and demand that any and all means be used to end this crisis.

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About RANBCG

Rise Above Now Business Consulting Group (RANBCG) is a management, marketing and capability-building consulting firm based out of the Philippines specializing in the healthcare industry. RANBCG, with its 50 years of collective healthcare experience from its roster of consultants, has been a trusted partner of pharmaceutical companies in conducting medical conventions, virtual engagement sessions and physical capability-building workshops for healthcare workers. In 2021, RANBCG was the partner of the Department of Health in holding resiliency workshops for all healthcare professionals amidst the challenges brought about by the COVID-19 pandemic.

 

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^[1] https://www.cnnphilippines.com/videos/2023/4/19/DOH--Dengue-cases-up-by-94--in-Q1-of-2023.html

^[2] https://www.who.int/news/item/02-10-2023-who-recommends-r21-matrix-m-vaccine-for-malaria-prevention-in-updated-advice-on-immunization

 

Join the "Be a Wall" campaign : Vaccination drive against dengue #WallAgainstDengue

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The “Be a Wall” campaign  and Vaccination drive against dengue, launch by Sanofi Pasteur, the vaccine division of multinational pharmaceutical company and industry leader, Sanofi. 

Dengue remains to be one of the fastest-growing mosquito-borne diseases in the world.

The “Be a Wall” campaign to mobilize the citizenry in a nation-wide campaign against the spread of dengue was launched  aims to build awareness among Filipinos parents and inform them how they can better protect themselves and their loved ones against the fastest-growing mosquito borne disease. 

It also aims to educate them about the multi-pronged ways to prevent dengue infection – vector-control, disease information and vaccination.

The Be a Wall campaign engage Filipinos by inviting them to connect, share their experience, ask questions, and join a community that’s building the nation’s resistance against dengue. 

It aims to remind them of their role to step up the fight against the disease and to get involved by taking an active part in health matters that affect them and their families. 

Dengvaxia is the world’s first dengue vaccine. It provides protection against all four virus serotypes. It has been approved for people belonging to the age group 9-45 years.

Celebrities, doctors and medical people, media and bloggers and advocates were at the "Be a Wall" campaign launch held at the Novotel Hotel, Araneta, Cubao Quezon City on October 25, 2016. 

Maricel Laxa-Pangilinan, Christine Bersola-Babao, Paolo Abrera, Mommy Mel and her daughter Rika with Dr. Rubi Dizon who is the Medical Director of Sanofi and Dr. Lulu Bravo President of the Philippine Foundation for Vaccination, stand out to to build a wall against Dengue.

Maricel Laxa-Pangilinan, Multi-awarded Actress, Columnist, Award-winning Author and Triathlete, share her experience on dengue as she had twice. The first was when she was six years old and the second time when she was already married.

“As responsible Filipino moms, let our voices be heard to raise awareness on dengue and let’s spread the good news that it is now a vaccine preventable disease. Each of us can now be a wall against dengue,” Maricel said.

Paolo Abrera, sports and public affairs host, share his own story as when he got the virus, he was down and out for a number of days and this surprised him as it hit him at the peak of his health when he was so active in sports.

“It’s great news that there is a dengue vaccine now available in the market. As a public affairs anchor, I’m on top of the news everyday and it’s very alarming to note the rising dengue cases from different regions of our country. It’s definitely a relief for Filipino parents out there especially a father like me to be able to visit our doctors today and have our kids vaccinated,” Paulo said.

Christine Bersola-Babao, Celebrity mom,  shared she had dengue three times! She also expresses her support for the dengue vaccine.

“I am a mother of two and I want my kids (family) to be safe from life-threatening diseases like dengue. Aside from the vector control measures that we have been doing, we really need a new tool that will help us in fighting the epidemic and vaccination is the answer. I encourage other Filipino moms to ask their doctors about dengue vaccination today,” she shared.

The Philippines ranks among the top-three countries affected by Dengue.

Cebu City, for example, has just declared a state of calamity with over 5,821 dengue cases recorded as of October 2016. Other areas considered as the most infected hotspots include Metro Manila or NCR, Region IV-A or CALABARZON, Northern Mindanao, SOCCSKSARGEN, Central Luzon, and Western Visayas.

Join “Be a Wall” campaign for the health of our families and love ones and all. Get vaccinated too.  Visit your doctor to know what you can do so we can all be a #WallAgainstDengue.

Sanofi Pasteur Presents Updates and Truth About the Dengue Vaccine

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Sanofi Pasteur, the world leader in human vaccines, recently presents updates and truth about Dengvaxia, known as Dengue Vaccine. Sanofi Pasteur has invested in the research and development of a dengue vaccine for about 20 years.

Dengue is a high-profile and ongoing public health concern in the Philippines. During the press conference on Friday, October 21, held at The Dusit Thani Manila Hotel, Makati City, Sanofi Pasteur, presents full data and updates on dengue.

Dengue cases rose to epidemic levels in 2015 with an average of 220 reported cases per day.

The first known epidemic of severe dengue or dengue hemorrhagic fever anywhere in the world was recorded in Manila in 1953.

By the mid-1970s, severe dengue had become a leading cause of hospitalization and death among children in the region. Between 2004 and 2010, the Philippines experienced the seventh highest number of dengue cases in the world according to the World Health Organization (WHO).

2016 data suggests an increasing trend in reported dengue cases

In 2013, DOH reported 204,906 cases of dengue, the highest number recorded since the establishment of the National Dengue Prevention and Control Program in 1993. More than 200,000 dengue cases were reported in the Philippines in 2015, 80,000 more than were reported in 2014. In both September and October 2015, the number of reported cases rose above the epidemic threshold. 

Although the number of reported dengue cases slightly decreased in 2014, the 2015 data suggest an increasing trend in cases in the coming years. Recent data gathered by the Department of Health from January to 24 September this year shows an increase of 11.5 percent year on year across the country, with total dengue infections at 142,247 compared to 127,525 last year and 604 recorded fatalities 

Based on Philippine surveillance data collected between 2011 and 2015, an average of 220 dengue cases were reported in the country every day. In 2015, almost 50% of reported cases came from three most urbanized regions: Region 3 (17.6%), Region 4 (17.3%), and the National Capital Region (12.6%). Cases stemming from all four serotypes of dengue were reported in 2015.

Disease burden: US$345 million per year

The economic burden of dengue in the Philippines is substantial. A study published in 2015 estimated that between 2008 and 2012, clinically diagnosed dengue cases in the Philippines were associated with a direct medical cost (in 2012 US dollars) of $345 million annually. 

The study calculated the average cost of treatment per case to be $409, representing 16% of the Philippines’ 2012 per capita GDP. Sixty-five percent of cases were treated in inpatient hospitals, representing 90% of direct costs.

In addition to dengue’s burden on a household, the illness can adversely impact a country’s economy through a loss of productivity caused by the illness and pre-mature death, increased healthcare costs and a possible reduction in tourism.

Seasonality and global climate change

Dengue has become a year-round threat in the Philippines. However, data suggests that the number of dengue cases increases one to two months after the onset of the rainy season, resulting in a peak of dengue cases between July and November each year. 

The Philippines is severely affected by extreme weather events and is vulnerable to the effects of climate change. Vector-borne diseases like dengue may be particularly sensitive to both periodic fluctuations and sustained changes in global and local climates. Additionally, a study examining data from eight Asian countries including the Philippines over 18 years revealed a strong correlation between regional dengue epidemics and elevated temperatures associated with El Niño.

DoH implements a step-wise public vaccination program in 2016

The Department of Health announced on 4 January 2016 that one million (1M) nine-year-old Filipinos enrolled in government schools in Region 3, Region 4-A and the National Capital Region will be the first beneficiaries of the government-procured dengue vaccine. 

In a recent dengue vaccine cost-effectiveness study performed by Professor Hilton Lam of the UP-National Institutes of Health, a nationwide annual routine vaccination of nine-year olds starting in 2016 would lead to an estimated 24.2% reduction in dengue cases in the country over a five-year period. This would translate to 775,053 avoided cases of dengue, 502,000 avoided hospitalizations, 22,010 avoided deaths and almost Php 21 billion in avoided cost to society.

Beyond the Vial: A Social Value Business Model For Sanofi Pasteur’s Dengue Vaccine

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Dengue is a serious and complex disease. Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. The mosquitos that transmit dengue indiscriminately pass the disease amongst people of all ages and socio-economic levels. Aedes aegypti has been identified as the main dengue-carrying culprit, biting between 6 a.m. to 8 a.m. and 4 p.m. to 6 p.m. Another one is Aedes albopictus, has been discovered to have peak biting hours from 6 p.m. to 8 p.m. and 11 p.m. to 1 a.m. In tandem, these mosquito strains now make dengue a round-the-clock concern.

Dengue is a major public health priority. Dengue vaccination is a critical addition to the integrated disease prevention efforts needed to more effectively manage dengue burden. The tide of dengue could be better controlled through enhanced international collaborations in public health, and an innovative social business model with a vaccine at its core.

What's the best line of defense against dengue? About half of the world’s population lives in areas where dengue is endemic, and millions suffer its seemingly bone-breaking pain and severe fevers, each year. 

Sanofi Pasteur, the vaccines division of Sanofi,  is the largest company entirely dedicated to vaccines. Sanofi discovers, develops and distributes therapeutic solutions focused on patients’ needs.

Dr Su-Peing Ng, Global Medical Head Sanofi Pasteur and Professor Tikki Pang from Lee Kuan Yew School of Public Policy (2012 ) and at the World Health Organization (WHO) in Geneva, Switzerland as Director of its Research Policy & Cooperation department (1999-2012)

A media round table talks las September 20, 2016 held at The New World Hotel with with Dr Su-Peing Ng, Global Medical Head Sanofi Pasteur as she talks about Combatting Dengue with World's First Vaccine: From Innovation to Implementation and Professor Tikki Pang explains health Impact and value of dengue vaccination.

It was twenty years ago when the global healthcare leader, Sanofi Pasteur identified the potential scale of the dengue problem at its early stages, and began to put in place a set of innovative scientific and industrial solutions. In 2015, the dengue vaccine received its first market approvals. 

In July 2016, after more than two years of review processes and inputs from clinical trial data and from top global dengue and infectious diseases experts, the World Health Organization issued its recommendation that countries where the dengue burden is high should consider vaccine introduction as part of integrated dengue prevention and control measures.As of September 14th 2016, the vaccine was licensed in 9 endemic countries in Asia and Latin America and public immunization programs are underway in Brazil and the Philippines, while the vaccine is also available on the private markets in those countries as well as in Mexico and El Salvador. 

The story behind the vaccine is one of hard-earned research and development – but you’ve heard that story before. This story goes beyond the vial, as well: It’s about a new, social value business model that Sanofi Pasteur has built in collaboration with dengue-endemic countries and global health institutions. In time, it can help control dengue. But as importantly, it can help to support better healthcare outcomes in emerging markets by accelerating access to needed innovations. 

When Sanofi Pasteur first identified a viable dengue vaccine candidate, we saw the opportunity todevelop a health solution specifically for the countries where the dengue burden is highest. We wanted to make sure that people who lived in grip of dengue’s threat were the people for whom the vaccine is designed and delivered primarily. It sounds simple enough but in traditional pharmaceutical business models, this is often not the case. More often than not, travelers and other select groups of individuals from high-income countries have access to new preventive tools against tropical diseases first, at a premium, before these solutions are made available, often as many as 10 years later, in less rich economies, even if this is where the disease burden is heaviest. 

Our faith in this“flipping the model” approach was inspired by the scale of the dengue problem. Vaccines are widely considered among the most effective healthcare interventions against infectious diseases. They often confer protection against a disease that extends beyond the vaccinated to also the unvaccinated population. Given dengue’s massive spread, a vaccine could help national authorities in dengue-endemic countries achieve WHO 2020 objectives for dengue reductions in mortality (50%) and morbidity (25%) if it is implemented in large-scale public health programs1. 

We anticipated this, and began building robust public health collaborations and industrial resources essential to success. The global clinical development program of the vaccine included 40,000 participants in 15 countries across Asia and Latin America.  We invested in extensive skills training for healthcare personnel, upgraded healthcare facilities and increased prevention and education efforts. We captured new scientific insights into dengue epidemiology and transmission which is shared with host governments. In parallel, Sanofi Pasteur built a dedicated dengue-vaccine production facility that will allow large and cost-effective supply to support optimal uptake of the vaccine as needed around the world. 

Successful implementation of dengue vaccination programs can help governments in dengue-endemic countries to take control over the disease. Mathematical modeling of the vaccine’s impact indicate that if countries take up broad public vaccination programs in highly dengue-endemic countries like those that participated in the Phase III development of the vaccine, vaccination can help cut the burden of disease in half over five years. Healthcare systems’ loads can be lightened and they can attract further outside public health investment with demonstrated program results. Successful vaccination programs therefore have the potential to be catalysts for social and economic progress. Today, states like Paraná in Brazil are taking up the lead in this effort. Public program introduction of the dengue vaccine in Mexico has been recommended by CONAVA, that country’s National Vaccination Council. Countries like these that have participated in the clinical development of the vaccine can see the value in the entire process as well as in the potential future results. 

At Sanofi Pasteur, we welcome enhanced support and investment in the robust public-private collaborations that ensure broad reach for innovative health solutions like the dengue vaccine. Working together to establish balanced trust and long-term commitment to new ways of bringing innovation to people is critical to unlocking innovative business models’ fullest potential for improving public health worldwide.

Dengvaxia is the first vaccine licensed for the prevention of dengue in the world. The vaccine is produced in a dedicated production site in France with planned full-scale production capacity of 100 million vaccine doses annually. 

Additional information about Sanofi Pasteur’s dengue vaccine is available on the web at www.dengue.info.