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Health Health

it was introduced, the public health outcomes
in Fiji have been less clear. He attributes this
to the (global) unreliability of dengue data due
to the pandemic, and a lack of traction from
local health authorities. “We would love the
Ministry of Health and Medical Services to be
more interested in the outcomes of this project,
because really the data on dengue case burden
and incidence, that’s the Ministry of Health’s
data. But we’ve struggled a little bit to have
interest from the ministry in the outcomes of
this program. And part of that is that continuity,
some key people left the ministry over time.
Part of it is reflection [of the fact] we’re a small
NGO, we do not have people placed in Suva and
Nadi, we don’t have a presence in Fiji to keep
knocking on doors.”
Islands Business asked the ministry for
comment, but received no response before we
went to print. Training in mosquito trapping, specimen preparation and species identification is offered through the
New Caledonia has had a national Wolbachia Pacific Mosquito Surveillance for Impact project (Pacmossi). Photo: Pacmossi/SPC
program for five years.
Simmons says they are now “waiting with measures and put in place certain steps before countries
bated breath” for a recommendation from WHO in response introduce new vaccines. Vaccination should be considered a
to the Wolbachia pilots. While it has not stopped the roll out part of an integrated dengue prevention and control strategy.
of the intervention in other countries, it could ease the way. This includes adherence to other disease preventive measures
“I think there is no other intervention at the moment at such as well-executed and sustained vector control.”
this scale that compares to this,” he says, adding that a WHO Dr Saketa says SPC produced a position paper on dengue
recommendation would enable some lower income countries vaccines in 2016, and at that time there were some
to sit down with international donors and development reservations about the introduction of a vaccine, but that
agencies and discuss investment in such interventions. a lot has been done since then, and they are following its
WHO’s Western Pacific Region office in Fiji told Islands progress.
Business that the ‘guideline development process’ has “We’re really interested, we’re looking at it, watching,
begun and that “there is a prospect of refining WHO and hope to get more evidence around the use of this new
recommendations when additional high-certainty evidence vaccine. And we know that countries have to prepare because
becomes available.” one of the criteria for introduction of a vaccine is that it’s
Simmon says there are other obvious places where recommended for those [countries] that have endemic
Wolbachia [has potential] such as Honiara (Solomon Islands), dengue.”
Samoa, Tonga and Cook Islands. “But no intervention is free. Dr Saketa says countries can only prove that by having
And we, both the World Mosquito Program and the country serious prevalence studies. Again, it comes back to the need
pilots, need funds to be able to enable the activities to for better and more consistent data.
happen,” he stresses. She notes that while SPC does not oppose fogging/
There are other pilots underway. Last year the Marshall insecticide use, “we know that insecticide resistance is
Islands government selected Oxitec to trial the release of one of the major things that’s affecting the use of those
genetically engineered Aedes aegypti mosquitos on densely [methods].
populated Ebeye, where a severe dengue outbreak sparked a “ We’re working to see if we can have a standardised, more
state of health emergency in 2019. informed way of advising countries in terms of the use of
Oxitec’s technology involves production of non-biting insecticide and also to be able to address the issue around
‘Friendly’ male mosquitoes over time, which mate with insecticide resistance.”
invasive, biting Aedes aegypti females. Their female offspring But she says SPC is very supportive of the trial of new
cannot survive, which means fewer biting female mosquitoes technologies in dengue control; Wolbachia, Oxitec in Marshall
in the following generations. Islands and a new sterilization/irradiation technique in
Meanwhile 20 countries have licensed a dengue vaccine French Polynesia and Cook Islands . “We’re looking forward
(Dengvaxia) with other vaccines in development. As to to results and evaluation of these to see how they can also
whether this might be an option for the Pacific, WHO told be implemented in other countries if they wish to have these
Islands Business: “introduction of a new vaccine is a national tools as well.”
decision. WHO advises countries to implement certain

Islands Business, April 2024 23