New independent advocacy group DPAM unites experts in combating dengue

Dengue Prevention Advocacy Malaysia (DPAM), a newly launched independent advocacy group comprising non-governmental medical and community organizations, aims to synergize efforts in supporting the Ministry of Health Malaysia (MOH) for enhanced dengue prevention, management, and control.

DPAM is jointly led by the Malaysian Paediatric Association (MPA), the Malaysian Society of Infection Control and Infectious Disease (MyICID), the Malaysian Society of Infectious Diseases and Chemotherapy (MSIDC), the Malaysian Public Health Physicians Association (PPPKAM), in collaboration with Malaysian Society of Parasitology and Tropical Medicine (MSPTM), the Malaysian Medical Association (MMA), Asia-Pacific Academic Consortium for Public Health Kuala Lumpur (APACPH-KL), and Rotary International District 3300.

Malaysia experienced the worst dengue outbreak in 2019 with more than 130,000 cases and 182 deaths. [Int J Infect Dis 2022;124:240–247; Crisis Preparedness and Response Centre MOH] Although a significant reduction in cases was seen during the COVID-19 pandemic due to movement control measures, a sharp rise in dengue cases has been documented in 2023. From January to 3 June, there was a 158 percent increase in dengue cases and a 183 percent increase in deaths compared with the same period in 2022. [Available at: https://www.moh.gov.my/index.php/database_stores/store_view_page/17/2362. Accessed on 13 July 2023.]

During the official launch of DPAM, Dr Husnina Ibrahim, Deputy Director of Disease Control Division (Communicable Diseases), representing Datuk Dr Norhayati Rusli, Deputy Director-General of Health (Public Health), highlighted that this upward trend is expected to continue. “As Malaysia typically experiences a surge in dengue cases every 4 to 5 years, it was projected that an outbreak is due around this or next year, with an estimated number of cases potentially surpassing the historic 2019 outbreak,” she said.

Nevertheless, MOH’s efforts have yielded positive results in terms of prevention and control whereby the introduction of Wolbachia-infected mosquitoes significantly reduced dengue cases in 16 out of 19 localities by 33–100 percent. [Available at: https://www.nst.com.my/news/nation/2023/07/926205/health-ministry-says-no-wolbachia-infected-mosquitoes-released-negri. Accessed on 13 July 2023.] Additionally, through the implementation of comprehensive guidelines, proper training, and a critical review of dengue mortality, healthcare professionals have reduced the case fatality rate (CFR) by 87.3 percent from 2000 to 2021. [Available at: https://www.moh.gov.my/moh/resources/Penerbitan/Pelan%20Strategik%20/Buku_Pelan_Strategik_Pencegahan_dan_Kawalan_Denggi_Kebangsaan_Final.pdf. Accessed on 14 July 2023.]

Moving forward, MOH has drawn up the National Dengue Prevention and Control Strategic Plan 2022–2026 in an effort to reduce the number of dengue cases by 5 percent each year, while maintaining the CFR below 0.2 percent. [Available at: https://www.moh.gov.my/moh/resources/Penerbitan/Pelan%20Strategik%20/Buku_Pelan_Strategik_Pencegahan_dan_Kawalan_Denggi_Kebangsaan_Final.pdf. Accessed on 14 July 2023.] MOH also intends to reduce the CFR to 0 percent by 2030, which aligns with global targets set by the World Health Organization (WHO).

DPAM chairman Professor Datuk Dr Zulkifli Ismail is optimistic that these ambitious targets are achievable with active involvement from key stakeholders namely the government, civil society, academia, private sector, media, and the community to mobilize “whole-of-society” action. “The group’s scope of interest will be comprehensive, covering epidemiology, integrated vector management, environment, patient care, laboratory, and vaccines. In its capacity, DPAM will focus its efforts on healthcare professional education and communication, public education and communication, local research, guideline recommendations, as well as policy recommendations,” he added.

Zulkifli also emphasized that DPAM intends to foster and strengthen regional collaboration by working closely with the Asian Dengue Voice and Action (ADVA), a regional advocacy group, towards a common goal. The 7^th Asia Dengue Summit in June 2024 marks the first collaborative initiative with ADVA, as Malaysia has been selected as the host country.

In order to create a “whole-of-society” approach to achieving six goals, DPAM released its Resolution Paper, which included a number of important strategies that all pertinent stakeholders can implement. Zulkifli said DPAM will play its part to implement the strategies by focusing its efforts on a number of initiatives. He reiterated the DPAM’s hope for all stakeholders including the civil societies, academia, private sector, media, and the public, to join forces in realizing the goals outlined in the Resolution Paper, to help Malaysia win the battle against dengue.

DPAM’s key strategies for a whole-of-society approach.
·       Acquisition of accurate epidemiological data to ensure effective dengue prevention and control activities as well as outbreak preparedness and response.
·       Delivery of sustainable, efficient, and effective integrated vector management strategies.
·       Implementation of cross-sectoral environmental management activities to reduce the entomological risk of dengue transmission.
·       Reduction of the dengue case fatality rate (CFR).
·       Accessibility of laboratory diagnoses and diagnostic tests of dengue, generating accurate and timely results.
·       Provision of individual and, ultimately, universal access to dengue vaccines as part of the dengue prevention strategy.

DPAM to focus on the following initiatives.
·       Empowering healthcare professionals through educational activities.
·       Rallying the support of relevant stakeholders to conduct consistent and sustainable public education and awareness initiatives.
·       Engaging relevant stakeholders to advocate for adequate financial allocation on key activities such as vector control and research.
·       Conducting dengue-related research in collaboration with other stakeholders.
·       Assisting/ supporting MOH in the development or revision of guidelines.
·       Disseminating research findings through media to mobilize whole-of-society action against dengue.