A nod for prevention

The island-wide campaign to destroy mosquito breeding grounds, planned for this weekend, is a most welcome move given the prevalence of dengue in Sri Lanka, apart from some cases of malaria. The two-day program spearheaded by the Presidential Task Force on dengue and the Ministry of Health should be a precursor to regular programs of this nature.

While the Western Province seems to be leading the way in terms of dengue prevalence, no province has been spared by the dengue mosquito. Although it is generally known that the disease, which can be fatal, is caused by mosquito bites, more awareness should be created on the need to clear any potential breeding sites. This is a job especially for the electronic media.

I recently attended an ‘Ecohealth’ conference in Montreal, Canada, where the close link between ecology and health was highlighted. A well-maintained ecological system can lead to better health prospects for everyone. If our environment is clean, there is little room for diseases such as dengue to spread.

One of the factors highlighted at the conference was the livestock-human link which can cause many diseases. Several prevailing diseases have ‘jumped’ from animal to man. Moreover, unhygienic conditions at livestock farms can give rise to other diseases such as dengue.

The conference was an eye-opener in the sense that more research is needed on animal-borne diseases. At the conference, researchers from around the world presented the latest research on mosquito and other animal borne diseases such as Rift valley disease, West Nile, chikungunya and Chagas. Many researchers also focused on Ebola, which has killed more than 1,000 people in West Africa so far. It was also pointed out that climate change could mean the rise of more mosquitoes as conditions become favourable (hot and humid) for them to reproduce swiftly.

Every disease is global now, so research activities must essentially be global. Even ultra-developed Japan, recently reported its first dengue cases in more than 70 years. It is only through research that we can eventually find cures and other associated forms of disease control such as vaccines. It was through research that a Canadian lab developed an experimental vaccine for Ebola recently. This was later provided to the West African countries.

Localised

Sri Lanka too needs more localised research on diseases such as dengue, malaria and TB. After all, research conducted in and applicable to developed countries may not be of any benefit here. Only local experts are likely to have an intimate knowledge of tropical diseases. Research is not only about an end product such as vaccines or pharmaceuticals, but also about preventive actions. Our researchers should be given opportunities to take their research to the world and if there are any potential disease control products, they too should reach commercialisation after clinical testing.

In the meantime, the adage that ‘prevention is better than cure’ still applies. Most, if not all, preventive measures incur no costs at all. It does not cost you anything to clear excess water from your drain or to remove an old tyre from the garden. Some measures do cost money, but it is well worth the cost - a mosquito net may be slightly expensive but you get a good night’s sleep with one on. If you go outside at dusk or night, wear clothes that won’t let mosquitoes in. There are some solutions which are not so cost-effective, such as mosquito coils which also have certain health effects. Mosquito Repellants, which are gaining momentum here, are also not very effective.

There has been much speculation about biological control, but we already have some biological control measures in place, without really thinking about it. If you have fish in a pond, they will eat the mosquito larvae. But genetic engineering is also coming to the fore - British biotech firm Oxitec has altered the DNA of the Aedes aegypti mosquito to prevent it from spreading the potentially deadly virus.

Oxitec's new factory in the Brazilian city of Campinas, outside Sao Paulo, is the first in the world to launch production of genetically modified (GM) mosquitoes to target dengue.

The mosquitoes, which Oxitec has dubbed OX513A, have been bred to carry a sort of genetic self-destruct mechanism that causes their offspring to die before they reach sexual maturity, preventing them from reproducing. The company says if sufficient numbers of GM males are released into the wild, they will mate with females on a large enough scale to significantly reduce or even wipe out the dengue-carrying population.

Reproduce

“Once they're released, the mosquitoes look for wild females to reproduce. But thanks to this genetic modification, which is transmitted, all their offspring die before reaching adulthood, so they can neither bite nor transmit the dengue virus,” an official has said. These new approaches are necessary to fight dengue which has seen its deadliest outbreak worldwide this year with nearly 100 million cases. Indeed, the current global attention on Ebola has perhaps masked other killer diseases such as dengue and malaria. But every deadly disease deserves the same attention from governments. Medical authorities and research labs.

Among the other diseases that should gain serious attention are Middle East Respiratory Syndrome (MERS), bird flu and drug resistant TB.

Sri Lanka’s health indices are often on par with those of the developed world and the authorities should strive to keep it that way. The country has one of the most comprehensive vaccination and immunisation programs in the world, which has kept most disease at bay among adults and children.

Sri Lanka should essentially have an emergency mechanism to deal with the likes of Ebola since we are a connected society. Thousands of travellers enter our shores every day and they cannot all be screened for diseases. We should be ready to face any eventuality, given the prevalence of Ebola in West Africa.

As the saying goes, Health is Wealth. This applies to both individuals and the country. A population that is afflicted with disease will not be economically productive. It is thus essential to keep these deadly diseases away, using a combination of factors and methods.