Public Health Entomology

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2 Public Health Entomology Challenges and Next Steps Haroldo Bezerra PAHO/WHO

3 Contents Background and challenges The proposal to Public Health Entomology in the Americas The TAG Public Health Entomology PAHO/WHO Next steps: The main recommendations of TAG PHE

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5 Vector-Borne Diseases (VBD) High mortality rate in the tropics and subtropics; Disability Adjusted Life Years (DALY) and importance of VBD, Malaria represents the greatest burden. McGraw & O'Neill l 2013

6 Vector-Borne Diseases (VBD) Vector-borne diseases contribute approximately 17% of the global burden of infectious diseases Townson et al. 2005

7 Vector-Borne Diseases (VBD) +500/arboviruses 110 pathogenic to humans 265 transmitted by mosquitoes ETEC DENV ESL EE DENV WN EE DENV DENV CHIKV DENV ZIKA FJ CHIKV EE WN CC ZIKA WN DENV FJ CHIK CC FVR CHIK ETEC CC DENV DENV EJ CHIK DENV EJ CHIK DENV ZIKA Anna-Bella Failloux 2014

8 Surveillance and vector control Public Health Entomology We are doing things right? Loss of specialized human resources Lack of quality control Inadequate impact evaluations Little engagement outside of the health sector

9 Insecticide resistance Decreases the efficacy of interventions relying on insecticides Limited compounds approved for public health use

10 Public Health Entomology in the Americas Strengthen of the entomological practice in public health Implementation of IVM Insecticide Resistance Monitoring & Management Technical Advisory Group

11 TAG PHE One of the mandates of the Pan American Health Organization/World Health Organization (PAHO/WHO) is to provide technical cooperation to countries in the prevention and control of vector-borne diseases (VBD). The Technical Advisory Group on Public Health Entomology (TAG - PHE) will serve as PAHO s principal Advisory Group to the Director, on all relevant aspects of this specialty area in the Americas. TAG-PHE will anchor and support PAHO's recommendations on technical, scientific and operational needs to strengthen public health entomology and Integrated Vector Management - IVM, as a tool and a model, to support the prevention and control of VBD in the Americas, according to the mandates and guidelines of PAHO/WHO. TAG-PHE as one of the most important mechanisms of the PAHO/WHO to strengthen the response and delivery of technical cooperation in the monitoring, prevention, control and elimination of VBD, including an accelerated effort to properly respond to outbreaks and emergencies.

12 TAG MEMBERS Dr. Gustavo Sanchez Tejeda Director del Programa de Enfermedades Transmitidas por Vectores CENAPRECE Secretaría de Salud México Dr. Oscar Daniel Salomon Director del Instituto Nacional de Medicina Tropical Ministerio de la Salud de la Nación Argentina Dr. Karen Polson-Edwards Assistant Director - Surveillance, Disease Prevention & Control Caribbean Public Health Agency (CARPHA) Trinidad and Tobago TAG PHE Chair Dr. Milena Beatriz Mazzarri Peloza Ministerio del Poder Popular para la Salud Venezuela Dr. Steven Ault PAHO retired United States of Americas Dr. Audrey E. Lenhart Division of Parasitic Diseases and Malaria Entomology Branch Centers for Disease Control and Prevention (CDC) United States of Americas Dr. James J. English Department Head, Training & Education US Navy Entomology Center of Excellence United States of Americas

13 The first meeting of the Technical Advisory Group on Public Health Entomology (TAG PHE), was held from 8 to 10 March 2016 at the PAHO headquarters in Washington, DC. The topics discussed covered two scenarios: I. Vector control and prevention actions in regards to the current public health emergency of international concern (PHEIC) declared by WHO on the epidemic of Zika virus infections in the Americas. II. Review and analysis of the actions that can be implemented in the medium and long term for the prevention and control of vectors responsible for vector-borne diseases (VBD) in the Americas.

14 The main recommendations made by the TAG PHE SURVEILLANCE Conduct surveillance of insecticide resistance, as immediate entomological surveillance. Analyze the information generated on insecticide resistance for public health purposes at the national level. Develop and implement plans to manage resistance in each country based on subsequent analysis. Define a single integrated surveillance system, that would be practical and could provide necessary routine entomological information in a sustainable way to support the decision-making process, including monitoring of vectors and their behavior change.

15 The main recommendations made by the TAG PHE TRAINING IN ENTOMOLOGY AND PREVENTION AND CONTROL OF VECTORS Investment in human resources for vector control in the short, mid and long-term (career pathways) is urgently needed. Programs cannot operate to protect the public health without adequate personnel. Various types of certification programs are needed to accompany training and refresher courses. Determine country capacity, identify needs, and assess the necessary levels of training required. Identify potential training centers and opportunities to collaborate on human resource development including South-South cooperation

16 The main recommendations made by the TAG PHE MONITORING AND EVALUATION Evaluate the actions of vector control, field operational teams, and procedures used in prevention and control activities. Focus on these actions in terms of impact (including that of disease transmission) and cost-effectiveness. OPERATIONAL RESEARCH Propose, support and develop operational research projects on entomology as well as projects regarding interaction between the vector and the environment, society and urban development (infrastructure and sanitation), among others. SOCIAL MOBILIZATION AND ALLIANCES Establish, promote and support partnerships with different local and central governments to improve the quality and access to basic services (water supply and water security, solid waste disposal, etc.); that can impact reduction of entomological risk for vector-borne diseases. Encourage the full involvement of local governments (mayor, city councils and advisors) to support the improvement and access to basic sanitary services.

17 The main recommendations made by the TAG PHE VECTOR CONTROL AND PHEIC OF ZIKA VIRUS INFECTIONS Strengthen and enhance existing measures of entomological surveillance and vector control for their current effective use in order to help reduce the risk of transmission of VBDs including Zika virus infection, and to ensure the achievements of the various existing elimination efforts in the Americas. Strengthen and enhance existing entomological surveillance and vector control measures, emphasizing the protection of pregnant women in order to avoid contact with the culpable vector. Encourage the rapid, robust and accelerated evaluation of new and supplemental tools for Aedes control, such as Wolbachia infections and genetically modified insect technology to ensure adequate technical cooperation and funding for this purpose.

18 Thank You! Muchas gracias!