Intersectoral approaches to dengue vector control.

Medical entomology in the context of urban vector control, especially for dengue, can be likened to the tail of a dog. Vertically structured Aedes aegypti campaigns such as run by Gorgas and Soper earlier this century relied on sufficient legislative backing for vector control to ensure that the tail was capable of wagging the dog. Under these conditions, especially where individual rights do not intrude, vertical programs will be successful. The global expansion of dengue, dengue hemorrhagic fever and its vectors, plus growing trends towards urban/periurban living indicate a more serious scenario than at present. In 1987, the Brundtland Report: "Our Common Future" decried sectoralism in problem solving. Following the United Nations Conference on Environment and Development (UNCED) in 1992, the resulting Commission on Sustainable Development has promoted the intersectoral message of health, environment and development. The WHO/FAO/UNEP/UNCHS Panel of Experts on Environmental Management for Vector Control has promoted this for some time and is attempting to build multidisciplinary projects against urban vector borne disease. Adequate solid waste management and recycling will reduce numbers of water bearing containers infested with Aedes aegypti and provision of reliable piped water supplies will impact heavily on infested water storage containers. Both should be encouraged as viable control options. For much of the world, vertical programs have been reported as prohibitively expensive, and unacceptable intrusion on human rights and thus unsustainable in the modern economic context. However there are successful modern examples.(ABSTRACT TRUNCATED AT 250 WORDS)