Mosquito-transmitted disease crisis in Latin America WHO

February 2017

2

WHO 2017

CONTENTS

I. INTRODUCTION

II. OVERVIEW

A. COMMITTEE’S BACKGROUND

B. ACHIEVEMENTS

III. MOSQUITO-TRANSMITTED DISEASE CRISIS IN

LATIN AMERICA

A. BACKGROUND

B. CURRENT SITUATION

IV. POSSIBLE SOLUTION

ANNEX I: LIST OF COUNTRIES

ANNEX II: INFORMATION ABOUT COUNTRIES

ANNEX III: REFERENCES

3

I. INTRODUCTION

Dear delegates of the World Health Organization,

During this debate, you, as representatives of a country, will be dealing with a topic of major

importance: Mosquito-transmitted disease crisis in Latin America. The debate will require from certain

skills such as diplomacy, your power of analysis, your innovative ideas and above all, your willingness

to reach a viable resolution to the topic. We, as your staff, encourage you to use all your abilities

throughout the debate, being sure that your high standards and your maturity during the discussion of

these issues will enhance the outcome of our committee.

Welcome to the Olinca Model United Nations (OLINMUN) 2017.

Yours sincerely,

Chiara Gómez Blanno

Head of Committee of WHO

Andrés Figueroa Alcaraz Pablo de la Peña González

Chair of WHO Moderator of WHO

María Delgado Delgado

Deputy Chair of WHO

NOTE: We urge you to carefully read this piece, as it may be a very helpful tool and source of

general information for your topic. We urge delegates to read the delegate handbook, as the

committee will work following the rules that are mentioned and any delegation not following

them will be sanctioned with a warning.

4

II. OVERVIEW

Mosquito borne diseases in Latin

America, such as dengue, Zika

and chikungunya, have caught the

attention of the World Health

Organization since 2014. Due to

this (among other affairs), WHO

has coordinated the Department of

Control of Neglected Tropical

Diseases, in charge of policies and

strategies to enhance global

access to interventions for the

prevention, control, elimination and

eradication of neglected tropical

diseases, including some zoonotic

diseases. WHO as well, supports

the Member States to expand

access to prevention, diagnosis,

treatment and care interventions

for all those in need, according to

the resolutions established with the

World Health Assembly.

Today, WHO aims to prioritize the

public health needs of poor and

marginalized populations and

provide technical and strategic

guidance in key areas, principally

“donated medicines”.

The World Health Organization

delivers interventions through

appropriate technology at

sustainable cost and with the help

of international partners, supports

Member States in the coordination

and integration of national control

programs with sectors such as

education, agriculture and

veterinary public health.

A) Committee’s Background:

The World Health Organization

(WHO) is a specialized agency of the

United Nations that is concerned with

international public health. It was

established on 7 April 1948,

headquartered in Geneva,

Switzerland.

WHO is a member of the United

Nations Development Group. Its

predecessor, the Health Organization,

was an agency of the League of

Nations.

The constitution of the World Health

Organization had been signed by 61

countries on 22 July 1946, with the

first meeting of the World Health

Assembly finishing on 24 July 1948. It

incorporated the International Office

d'hygiène publique and the League of

Nations Health Organization.

Since its creation, it has played a

leading role in the eradication of

smallpox. Its current priorities include

5

communicable diseases -in particular

HIV/AIDS, Ebola, malaria and

tuberculosis- and the mitigation of the

effects of non-communicable

diseases; sexual and reproductive

health, development, and aging;

nutrition, food security and healthy

eating; occupational health;

substance abuse; and driving the

development of reporting,

publications, and networking.

WHO is responsible for the World

Health Report, a leading international

publication on health, the worldwide

World Health Survey, and World

Health Day (7 April of every year).

The head of WHO fulfills the following

objectives as defined in its

Constitution: to act as the directing

and coordinating authority on

international health work; to establish

and maintain effective collaboration

with the United Nations, specialized

agencies, governmental health

administrations, professional groups

and such other organizations as may

be deemed appropriate; to assist

Governments, upon request, in

strengthening health services; to

furnish appropriate technical

assistance and, in emergencies,

necessary aid upon the request or

acceptance of Governments; to

provide or assist in providing, upon

the request of the United Nations,

health services and facilities to

special groups, such as the peoples

of trust territories; to establish and

maintain such administrative and

technical services as may be

required, including epidemiological

and statistical services; to stimulate

and advance work to eradicate

epidemic, endemic and other

diseases

B) Achievements:

WHO’s support to different

governments in all aspects of health

has led to many historic

achievements: sustained control of

communicable diseases including

eradication of malaria, controlling

lymphatic filariasis and many vaccine

preventable diseases, such as polio.

The march to elimination of

Lymphatic Filariasis, a mosquito-

borne disease, is significant as it was

once endemic in 25 islands. With

WHO’s assistance and suitable

measures by the government such as

systematic case detection, treatment

and mosquito control, as well as the

implementation of Mass Drug

Administration (MDA) in 2004,

6

microfilaria rate declined from 18.5%

in 1951 to zero by 2009.

III. MOSQUITO-

TRANSMITTED DISEASE

CRISIS IN LATIN AMERICA

A) Background:

Aedes mosquitoes are insects

abundant in Latin America, but they

are present all around the world as

well. The mosquito transmits three

borne diseases: dengue, chikungunya

and yellow fever, across tropical and

subtropical regions around the world.

It has come to the attention of the

World Health Organization the

amount of Zika, Chinkungunya and

yellow fever cases that had sprouted

around the world, for the past two

years.

These cases are not only based on

the transmission of the diseases,

causing

their principal symptoms (such as

headache, muscle and joint pain, mild

fever and rash) but also on the

thousands of deaths and born babies

with malformations because of

pregnant women infected. Brazil,

Colombia, El Salvador, Guatemala,

Mexico and Venezuela are some of

the countries who have experienced

the mosquito outbreaks for the past

three years. These diseases

extended from Africa (1947) to East

Asia, arriving later to Latin America.

B) Current Situation:

Nowadays Northern and Central

America, as well as East Asia are

considered to be potential outbreak

regions. One specific area to be

considered of higher risk is Puerto

Rico. In these regions, the spread of

Aedes mosquitoes has been a

principal cause of hospitalization and

death of thousands of children and

only these regions have presented

around 56,000 severe cases for the

past three years.

Since 2014 the World Health

Organization keeps convening the

Emergency Committee under the

International Health Regulations in

order to talk about this topic and take

on possible measures to control the

problem. One of the most important

meetings was regarding the Olympic

Games that took place on Brazil,

2016, as it is one of the potential

7

outbreak areas. WHO was able to

take certain measures of prevention

so that the event could conclude in an

adequate and risk-free way.

Two weeks after the declaration of a

public health emergency of

international concern, WHO launched

the global Strategic Response

Framework and Joint Operations Plan

against Zika virus outbreaks (which

have been more than the other

viruses). The strategy was initially

developed with input from over 30

operational partners, and focused on

coordinating activities across three

core areas: surveillance, response

and research. The global response to

Zika is coordinated from WHO

headquarters in Geneva through the

Zika incident-management structure

(IMS), which enables a dedicated

incident manager to draw on

expertise and resources from across

the Organization. The IMS was

replicated at regional level.

WHO is aware that right now or at

least for the next decade, this

situation cannot be completely

eradicated but indeed controlled so

that risk of infection becomes smaller.

The committee knows that the world

is facing nature and genetic affairs,

so it is hard to find (as a massive

solution) what could help alleviate the

newly introduced chikungunya, zika

and dengue virus as potentially lethal

mosquito-borne diseases.

IV. POSSIBLE SOLUTION

A very important contributor to the

virus spread is the fact that

mosquitoes that are not infected with

these viruses can bite any person

who has it and instantly become

carriers that will later on spread it.

Hence, it is important that all

governments who had seen their

country experience an outbreak, take

certain measures and cautions with

the treatment of the people infected,

as it foments the virus spread and

can be merely lethal.

The World Health Organization invites

affected countries to participate in the

Emergency Committee meetings as

well as to take action in governmental

and national levels to avoid the Aedes

mosquitoes spread and infections, by

stating and regulating the mandatory

use of home preventions and

cautions, to start avoiding this threat.

Also, WHO advices the affected

countries to attend and invest on the

8

scientist community that may help

attacking the virus from its core, as

well as the crucial investment on

caution and prevention education for

the population of regions where

outbreaks occur.

9

ANNEX I: LIST OF COUNTRIES

1. Argentina

2. Bahamas

3. Belize

4. Bolivia

5. Brazil

6. Paraguay

7. Canada

8. Costa Rica

9. Cuba

10. Colombia

11. Guatemala

12. France

13. Germany

14. India

15. Indonesia

16. Italy

17. Dominican Republic

18. Mexico

19. Myanmar

20. Peru

21. Philippines

22. Thailand

23. United States of America

24. Venezuela

25. Chile

10

ANNEX II: INFORMATION ABOUT THE COUNTRIES

Brazil:

In Brazil, the most common of all viruses is Zika. Clusters of cases of acute illness have been

reported from various regions since late 2014, and in April 2015, Zika virus was identified as the

etiologic agent. In May 2015, the Brazilian Ministry of Health recognized circulation of Zika virus in

Brazil. We report epidemiologic findings for an ongoing outbreak of acute illness in the population of

Salvador, the third largest city in Brazil. Brazil's Zika outbreak, which grew explosively after the virus

first appeared in the country a year ago, appears to have peaked, with fewer new infections and

cases of birth defects, new research suggests. Zika cases hit a high of nearly 8,000 suspected new

infections in Brazil in March and have declined steadily since then to fewer than 200 a week.

United States of America:

Local mosquito-borne Zika virus transmission has been reported in the continental United States,

many areas in the United States have the type of mosquitoes that can become infected with and

spread Zika, chikungunya, and dengue viruses. Recent outbreaks in the continental United States of

chikungunya and dengue have been relatively small and limited to a small area, but areas with past

outbreaks of chikungunya and dengue are considered at higher risk for Zika. These include U.S.

territories like Puerto Rico, the U.S. Virgin Islands, and Guam. Local outbreaks have also been

reported in parts of Hawaii, Florida, and Texas.

Mexico:

Mexico’s most present virus since 2000 until today is dengue. The number of cases of dengue was

increasing rapidly between 2000 and 2006. Indeed, numbers continued to rise until 2013 when more

than 50,000 cases were reported for the year (an average of more than 4000/month). One possible,

at least partial, explanation may be that changes in climate have allowed dengue mosquitoes to thrive

in environments where they were previously scarce. People in such areas are unprepared for

dengue; they may not have instituted prevention programs, and may have been slow to receive

correct diagnosis. The migration of people affected by dengue from one region to another may also

have helped the disease spread, provided there were host mosquitoes in the destination region.

The good news is that the number of dengue cases in Mexico in 2014 has fallen from its 2013 level

by about 50%, so the dengue epidemic may finally be on the wane. As of 24 November 2014, 28,109

cases had been reported for the year, an average nationwide rate of 23.47 cases/100,000 people.

11

Mexico’s dengue prevention programs were not very successful when the problem became bigger,

but the programs did become better after the first decade.

Costa Rica:

Chikungunya cases have increased 20-fold since last year when the virus first arrived in Costa Rica.

While chikungunya is rarely fatal, patients can experience pain in their joints for up to a year after

contracting the virus. A new study released in the scientific journal “Neurology” last month also

showed that those infected with chikungunya were more likely to later develop encephalitis, a

potentially fatal brain inflammation. Costa Rica has had 3,700 cases of chikungunya in 2015, and

more than half of these infections occurred in the last two months.

According to the Health Ministry, the number of people infected with dengue has also increased this

year, with 14,322 confirmed cases. Nearly 75 percent of these infections occurred in Guanacaste and

Puntarenas. While the virus usually lurks in highly populated areas, it has also now spread into more

rural zones. At one point in September, the entire 300-person village of Arado in Guanacaste was

reportedly infected with dengue. Dengue fever has long been common in Costa Rica’s coastal

regions, but Health Ministry officials are concerned about the spike in infections. In 2013, nearly

50,000 people in Costa Rica were infected with dengue, an all-time record. The next year, the

number of cases dropped significantly. Since dengue is a cyclical disease, the Health Ministry says

the slight increase this year could signify the beginning of another spike.

12

ANNEX III: REFERENCES

http://www.who.int/mediacentre/factsheets/fs327/en/

http://www.who.int/topics/zika/en/

http://www.who.int/emergencies/zika-virus/mediacentre/press-releases/en/

https://www.cdc.gov/zika/geo/active-countries.html

http://www.who.int/emergencies/zika-virus-tmp/response-zika-2017.pdf?ua=1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516305/

http://www.who.int/topics/dengue/en/