ESHS/HSS Annual Meeting

Development before health? Standardizing dengue fever control in postwar Southeast Asia

• In Event: (Re)thinking Histories of Disease in the “Tropics” (III)

English Abstract

In the 1970s, decades before the World Health Organization (WHO) classified dengue fever as a “neglected tropical disease”, Southeast Asian countries sought to standardize guidelines for dengue control. Despite vigorous exchange in conferences and regional meetings, this was a difficult task. Although the region was home to the most successful mosquito control program in Singapore, national differences led to disagreement over the importance of prevention and treatment in dengue control. In well-funded countries like Singapore and Malaysia, pursuing a zero-dengue strategy meant that prevention via mosquito suppression was of prime importance. On the contrary, in overburdened health departments in Indonesia and the Philippines, only “severe” cases that required hospitalization were deemed significant, leading to a focus on clinical case management. As scientists debated these approaches, they argued that environmental, economic, and even sociopolitical differences between tropical countries precluded the creation of a gold standard approach to dengue. Technical debates about diagnostic criteria and mosquito control methods thus became a site for scientists to question the unity of Southeast Asia, and to explicitly argue that economic development had to precede health, rather than follow from its implementation.
Exploring these debates reveals that apparently technical scientific standards were inextricable from wider socioeconomic considerations within Southeast Asia. Furthermore, this case study highlights the importance of networks within Southeast Asia for developing global health responses to dengue, suggesting that dengue was never neglected in the tropics.

Author

• Timothy Sim, University of Cambridge