The Vice Minister of Health, Bonifácio Mau Coli dos Reis, participated in the official launch of the “National Commission for Vector-borne Infectious Disease Control and Anti-Dengue Campaign”, at the Novo Turismo Hotel, in Dili.
The aim of this launch is to strengthen the technical committee for the implementation and control of the vector and the committee for clinical management of dengue fever, by conducting campaigns to fight this disease and also to analyse the terms of reference and the composition of this committee.
The Vice-Minister of Health noted that “since the Restoration of Timor-Leste’s Independence, we have faced many problems, including several disease (infectious and non-infectious diseases). Being a tropical country, we also have the risk of tropical diseases, and our country is also considered as an endemic zone for several infectious diseases caused by vectors. Concrete examples are Malaria and Dengue, whose vectors are mosquitoes.
In Timor-Leste, Dengue is one of the problems of public health, with cases arising frequently within the community, particularly in the rainy season, creating conditions that favour the breeding of the vector. From 975 cases in 2019, it has moved to 1450 cases in 2021, with a lethality rate of 0,7%. The disease disproportionately affects children, with those in the age group between 1 and 4 years having a lethality rate of 0,4%, and those in the age group between 5 and 14 years having a lethality rate of 0,2%. The first cases of dengue were registered in Dili, Baucau, Bobonaro, Covalima, Liquiça and Manatuto. Malaria cases have been decreasing every year and the National Program against Malaria will move forward with the application process for Malaria Free Certification, next year.
In theory, the vector is a living organism that can transmit infectious pathogens from person to person, people to animals, or vice versa. Most of these vectors are blood-sucking insects, which ingest and then inject disease-producing microorganism into people’s bodies. These microorganisms can be parasites, bacteria, and also viruses. Some vectors do not transmit diseases into our blood, but act as a means of transmission.
These vectors can be mosquitoes, flies, fleas, rats, dogs, among others. Most vector-borne infectious disease happen in tropical and subtropical areas, and disproportionately affect populations living in areas where the environment and sanitation are not good, are overcrowded, like refugee camps, poor neighbourhoods, etc. And we all also know that the distribution of these vector-borne infectious diseases in determined by a complex set of demographic, environmental, social, economic, travel, trade, poorly planned urbanization and other factors.
Comparing the reality of the implementation of programs to combat vector-borne infectious diseases (Dengue fever, Malaria, Lymphatic, Filariasis, Yaws, Worms, Zika, Chikungunya, Japanese Encephalitis, among others), the Malaria Program is the one that has shown the best and most significant progress, particularly if we compare it with the program to combat dengue fever, which continues to be one of the 10 major Public Health problems that annually causes more and more deaths.
The observation from World Health Organization External Review Team (WHO/WHO-TL) on the national Malaria program in February 2020 showed that the vector infectious Disease Services have not been centralized in a single location because there is no specific division for this subject. The External Review also recommended the creation of an Entomology and Vector Control division under the National Directorate of Disease Control. So far there is still no policy and strategy for the control of dengue and other vector-borne infectious disease.
The development of the policy and strategy on vector-borne infectious disease control, to integrate Malaria services into the Department of vector-borne Disease Control, is one of the national priorities within the Ministry of Health services, as well as the budgetary support to develop new plans and strategies for the Malaria program, which has already been supported by the Global Fund for the period of 2021-2023.
This budget also includes the development of a human resources and capacity building plan for the technicians that will integrate the Department of Vector-Borne Infectious Disease Control, which is a commitment from the Government to the Global Fund.
The Vice Minister, on behalf of the Ministry of Health, thanked the World Health Organization in Timor-Leste, the Agencies, donors and all stakeholders for their collaboration in this effort to reduce the prevalence and incidence of vector-borne infectious diseases in Timor-Leste, and for their support for the launching of this event.
The Ministry of Health, through the National Directorate of Disease Control, has already allocated a budget for this year, to recruit experts in entomology and vector control, to carry out an analysis of the gaps or discrepancy regarding the implementation of vector control in Timor-Leste, which will adopt the WHO standard of services, and that, according to the plan, will be held in the next quarter and will have the support of the World Health Organization.