Strengthening local expertise, health systems and equitable access to health technologies is essential to moving the dengue response from reacting to outbreaks towards sustained preparedness.
Dengue must be treated as a continuous health challenge rather than a disease that demands attention only when cases peak, Paula Reges, Special Advisor to the Global Coalition for Local and Regional Production, Innovation and Equitable Access, said during Foreign Policy’s Health Forum @ UNGA81 in New York on 23 September.
Reges participated in the panel “The Preparedness Challenge: Dengue as a Stress Test for Global Health Security,” alongside Prof. Asnawi Abdullah, Director General, Health Policy, Ministry of Health of Indonesia, and Dr. Emanuele Capobianco, Director of Global Health Security at Gavi. The discussion was moderated by veteran journalist Maggie Lake, founder of Maggie Lake Media.
Part of the forum’s Investing in Health Security session, the discussion examined how countries can move from reactive outbreak management towards stronger and more sustainable preparedness.
Dengue is increasingly testing health systems as climate change, rapid urbanization, population mobility and other interconnected pressures contribute to its expansion into new geographical areas.
Building preparedness before cases peak
Reges stressed that there is “no silver bullet” for dengue. Effective preparedness requires a combination of tools and actions, including prevention, community engagement, diagnostics, vaccines, primary health care and trained health professionals.
Drawing on Brazil’s experience, she noted that the dynamics of dengue are changing even in a country that has dealt with the disease for decades. Cases are appearing in areas where they were previously uncommon, creating new challenges for health professionals and health systems.
For Reges, this makes dengue both a stress test and a case study for health preparedness. Responding only when cases surge misses opportunities to act earlier and address some of the conditions that drive the disease, including social inequalities and urbanization.
She emphasized the importance of building local expertise and local technologies, and of using knowledge generated on the ground to inform public policies and investment decisions. Investment strategies, she argued, need to adapt to local priorities and experience rather than rely on approaches developed at a single point in time.
This also requires looking at health systems as interconnected ecosystems. Vaccination programmes depend on functioning diagnostics; diagnostics depend on access to primary health care; and effective primary care depends on health professionals having the capacity to recognize patients at risk of developing severe disease.
Strengthening each part of this ecosystem, Reges said, helps build more resilient health systems.
Putting local expertise and equity at the centre
Reges connected this approach to the work of the Global Coalition for Local and Regional Production, Innovation and Equitable Access, one of the outcomes of Brazil’s G20 Presidency.
The Coalition was formally established in May 2025 and works to strengthen local and regional production, innovation and equitable access to essential health technologies, particularly in developing countries.
She highlighted the Coalition’s first Call for Proposals, focused on dengue, as an example of how local communities and expertise can contribute to developing and delivering solutions.
Photo credit: FP/Jonathan Heisler
The Call sought initiatives to accelerate the development, production and deployment of vaccines, therapeutics, diagnostics and enabling technologies while strengthening local and regional capacities.
Reges stressed that equity needs to be incorporated from the beginning of the development of health products if technologies are ultimately to reach the populations that need them.
She also pointed to the experience accumulated over decades in dengue-endemic countries as an important resource for the global response. As dengue expands into new geographical areas, the knowledge and capabilities developed locally can help inform preparedness elsewhere.
The discussion, she concluded, should therefore move beyond seeing dengue as primarily a local or Global South concern. As transmission patterns evolve, dengue provides a broader opportunity to learn how stronger local capacities, sustained preparedness and equitable access can deliver better responses for communities worldwide.
