
In the face of a changing climate, now is the time for Asean member states to develop a cure for dengue.
As we mark Asean Dengue Day tomorrow, it is a timely wake-up call about the growing public health threat that dengue poses in our region and beyond. Dengue is not just a seasonal inconvenience -- it is a devastating disease that sends millions to the hospital every year, overwhelms public health systems, and causes significant suffering and death.
There are an estimated 100 to 400 million dengue infections globally each year, with Southeast Asia among the hardest-hit regions. Surprisingly, despite the widespread and deadly nature of this disease, there is still no specific treatment for it.
Patients with severe dengue receive only supportive care -- fluids, rest, and monitoring -- which aims to prevent symptoms from getting worse in the absence of an approved drug that could directly target the virus.
The lack of dengue treatments is not only a scientific challenge -- it is an equity issue. Families in affected areas, often with limited access to quality healthcare, are forced to manage the disease with few options. Children, older people, and those with underlying health conditions are particularly at risk. A severe case of dengue can quickly escalate, leading to complications like internal bleeding, shock, and even death. Even people with only mild symptoms are often unable to work for days or weeks.
For Thailand, dengue costs an estimated 14.2 billion baht ($440 million) annually, mostly from hospitalisations and lost productivity. It is therefore time that we invest in long-term solutions -- including medicines -- that can help reduce dengue's human toll and economic burden.
Although dengue vaccines are being introduced in our region, it will take time for them to be widely accessible, and even then, vaccination alone will not be enough. Covid-19 has shown us that having treatments alongside vaccines is essential.
Developing a new drug is an extremely costly process, often driven by the commercial pharmaceutical industry. While the private sector plays an important role, medical innovation for neglected diseases like dengue is often slow due to limited market incentives.
This is where the public sector should step in, supporting alternative, not-for-profit R&D models. This requires strong commitment and collaboration from government members of the Association of Southeast Asian Nations (Asean).
While no specific antiviral treatment for dengue currently exists, the positive news is that research and innovation are gaining momentum. Collaborative efforts -- including those led by academia, public health institutions, and public-private partnerships -- are advancing promising candidates. With continued support, these efforts could soon deliver safe, effective, and affordable options for patients.
One important initiative is the Dengue Alliance, where non-profit organisations joined forces with scientists from Brazil, India, Malaysia, and Thailand to foster South-South scientific collaboration and find treatments tailored to the specific needs of our communities. These initiatives are crucial and deserve greater political attention and financial support.
Encouragingly, many drug candidates have already shown promising results in initial studies. These have the potential to become treatments that can protect against severe dengue and also prevent the mass hospitalisation we see during outbreaks. Speeding up the testing and approval of new treatments -- while ensuring they are safe and equitably accessible -- will help get better care to people faster.
We also need to view dengue as more than just a medical issue. Its spread is fuelled by climate change, rapid urban growth, and poor sanitation. During the rainy season in Bangkok, for example, inadequate waste management exacerbates spikes in dengue by creating stagnant water pools that provide additional habitats for mosquito larvae to thrive.
Our response must therefore be multi-faceted: improving community awareness, strengthening early detection systems, ensuring access to diagnostics, and mobilising community action alongside scientific breakthroughs.
On Asean Dengue Day, we must recognise the importance of collaborative action. We must learn from one another, share data and strategies, and coordinate responses.
Asean can play a valuable role in supporting these cross-country partnerships in a way that reflects the region's spirit of unity and cooperation, bringing countries together to share experiences, join efforts, and support one another.
Let us channel our shared commitment into tangible collaborations that prioritise innovation, equity, and urgency. With the right tools, the right partnerships, and the right leadership, we can shift the trajectory of this terrible disease -- from endless cycles of crisis to new models of preparedness, treatment and care.
Dr Prasert Auewarakul is Head of the Emerging Infectious Disease Research Unit, Faculty of Medicine, Siriraj Hospital, and a founding member of the Dengue Alliance. Vanessa Daniel is Director, South-East Asia, Drugs for Neglected Diseases initiative (DNDi). The article marks Asean Dengue Day, June 15.