IPM Take
The Americas do not have a dengue problem in isolation anymore. They have an arbovirus-governance problem.
Multiple viruses are circulating through overlapping mosquito populations while climate, mobility and urban conditions reshape transmission. A system that maintains separate outbreak machinery for dengue, chikungunya, Zika, Oropouche and yellow fever will spend too much time rediscovering the same weaknesses.
Executive Summary
PAHO Member States have approved a new regional strategy for the prevention and control of dengue and other arboviral diseases covering 2026–2035.
The strategy follows the largest dengue epidemic ever recorded in the Americas. In 2024, the region reported more than 13 million dengue cases and over 8,400 deaths. Recent years have also seen major chikungunya outbreaks, geographic expansion of Oropouche virus disease and yellow fever cases in new areas.
The regional plan prioritises integrated disease management, combined epidemiological, entomological and virological surveillance, stronger clinical and laboratory capacity, and modernised vector control. PAHO specifically includes newer approaches such as Wolbachia-infected mosquitoes and irradiated-mosquito technologies.
Why it matters
- Public authorities: Separate disease-specific surveillance systems need to communicate quickly when the same vectors and environmental conditions support several threats simultaneously.
- Hospitals and clinicians: Early diagnosis and appropriate clinical management become harder when different arboviral infections produce overlapping syndromes.
- Municipalities: Sustainable vector control requires local environmental management rather than emergency insecticide campaigns alone.
The Americas have spent years becoming very good at declaring dengue emergencies. The new regional strategy is an admission that emergency response is no longer enough.
The epidemiological environment has changed. Dengue produced more than 13 million reported cases in the region during 2024, the largest epidemic on record. Chikungunya continues to generate large outbreaks, Oropouche virus has appeared beyond areas where health systems traditionally expected it, and yellow fever has re-emerged in new geographic locations. These diseases are different, but the systems expected to detect and control them repeatedly converge on the same laboratories, mosquito programmes, hospitals and surveillance teams.
That makes fragmentation expensive.
PAHO’s new ten-year framework attempts to organise arbovirus control around shared capabilities rather than a collection of parallel emergency responses. Epidemiological surveillance needs to talk to entomological surveillance. Laboratory data need to reach clinicians and vector-control teams. Environmental information needs to feed risk assessment before hospitals begin recording the consequences.
The emphasis on anticipation is politically significant. Public-health systems traditionally receive their strongest funding once an outbreak is already obvious, when case counts are rising and ministers face pressure to demonstrate action. Mosquito control works best much earlier, when reducing breeding sites, mapping vector populations and identifying favourable transmission conditions can still prevent those hospital admissions.
The strategy also recognises that spraying cannot be the whole policy. Insecticide resistance, environmental concerns and the expanding geographic range of vectors require more diversified approaches. Wolbachia-based programmes, in which mosquitoes carry bacteria that reduce their ability to transmit viruses, and sterile or irradiated-mosquito approaches are moving from experimental novelty towards components of integrated vector management.
Innovation, however, will not compensate for weak municipal services. Water storage, waste collection, drainage, housing and urban planning continue to shape mosquito breeding. That means arbovirus policy inevitably reaches beyond ministries of health into local government, infrastructure and environmental governance.
Clinical readiness is another underappreciated part of the strategy. When dengue, chikungunya, Zika and other arboviruses circulate simultaneously, diagnosis becomes more complicated. Some infections require primarily supportive care; others carry different risks in pregnancy or different probabilities of severe disease. Laboratories need the capacity to distinguish them quickly enough that surveillance remains useful and clinical decisions are informed.
The region’s political challenge is now consistency. Ten-year strategies survive only if budgets survive electoral cycles, vector-control teams remain employed between epidemics and local surveillance continues when case numbers temporarily decline.
Mosquitoes are not waiting for ministries to decide which disease programme owns the problem.
The new strategy is strongest where it recognises that governments should stop doing the same.
