Transforming Dengue Control: Scientific Challenges, Operational Gaps, and Elimination Prospects

Abstract

Dengue has evolved into the most widespread arboviral disease, now threatening nearly half the world’s population. Despite the availability of diverse control tools—from insecticides and Wolbachia-based methods to improved surveillance and vaccines—the global burden of dengue continues to rise. This review dissects the scientific and operational roadblocks undermining control efforts, including silent transmission by asymptomatic carriers, serotype co-circulation, antibody-dependent enhancement (ADE), and growing insecticide resistance. These challenges are compounded by rapid urbanization, climate change, fragmented surveillance, and weak intersectoral coordination. The authors advocate for a paradigm shift: integrating real-time entomological surveillance, climate-informed predictive models, and next-generation diagnostics within a strengthened Integrated Vector-borne Disease Management (IVDM) framework. Emphasizing community engagement, cross-sectoral governance, and transdisciplinary research, this paper outlines a forward-looking strategy that aligns innovation with implementation. Transforming dengue control from a reactive response into a proactive public health mission is critical to achieving the long-standing goal of dengue elimination.