Developing economies in countries of the South-East Asia Region have recognized many social, economic and environmental problems which promote mosquito breeding. The dengue problem thus exceeds the capabilities of ministries of health. The prevention and control of dengue requires close collaboration and partnerships between the health and non-health sectors (both government and private), nongovernmental organizations (NGOs) and local communities. During epidemics such cooperation becomes even more critical, since it requires pooling of resources from all groups to check the spread of the disease. Intersectoral cooperation involves at least two components:
- Policy adjustments among the various ministries and nongovernmental sectors.
Resource sharing should be sought wherever the dengue control coordinator can make use of underutilized human resources, e.g. for local manufacture of needed tools, seasonal government laborer’s for water supply improvement activities, or community and youth groups to clean up discarded tires and containers in neighborhoods. The dengue control programmer should seek the accommodation or adjustment of existing policies and practices of other ministries, sectors, and municipal governments to include public health as a central focus for their goals. For instance, the public works sector could be encouraged to adjust its policies to give first priority to water supply improvements for communities at highest risk of dengue.
Role of the ministry responsible for public works
The ministry responsible for public works and its municipal counterparts should play a key role in dengue control. They can contribute to source reduction by providing a safe, dependable water supply, adequate sanitation, and effective solid waste management. In addition, through the adoption and enforcement of housing and building codes, a municipality may mandate the provision of utilities such as individual household piped water supplies or sewerage connections, and rainwater (storm water) run-off control for new housing developments, or forbid open surface wells.
Role of the Ministry of Education
The Ministry of Health should work closely with the Ministry of Education to develop a health education (health communication) component targeted at school children, and devise and communicate appropriate health messages. Health education models can be jointly developed, tested, implemented and evaluated for various age groups. Research programmers in universities and colleges can be encouraged to include components that produce information of direct importance (e.g. vector biology and control, case management) or indirect importance (e.g. improved water supply, educational interventions to promote community sanitation, waste characterization studies) to dengue control programmers.
Role of the ministry responsible for the environment
The Ministry of Environment can help the Ministry of Health collect data and information on ecosystems and habitats in or around cities at high risk of dengue. Data and information on local geology and climate, land usages, forest cover, surface waters, and human populations are useful in planning control measures for specific ecosystems and habitats. The Ministry of Environment may also be helpful in determining the beneficial and adverse impacts of various Ae. aegypti control tactics (chemical, environmental and biological).
Role of Nongovernmental organization (NGOs)
NGOs can play an important role in promoting community participation and implementing environmental management for dengue vector control. This will most often involve health education, source reduction, and housing improvement related to vector control. Community NGOs may be informal neighborhood groups or formal private voluntary organizations, service clubs, churches or other religious groups, or environmental and social action groups.
After proper training by the Ministry of Health staff in source reduction methods, NGOs can collect discarded containers (tyres, bottles, tins, etc.), clean drains and culverts, fill depressions, remove abandoned cars and roadside junk, and distribute sand or cement to fill tree holes. NGOs may also play a key role in the development of recycling activities to remove discarded containers from yards and streets. Such activities must be coordinated with the environmental sanitation service.