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“The New England Journal of Medicine is the world’s most high impact, high profile medical journal. Publication in the journal reaches a global audience and is a testament to the highest quality medical research.” 

Director of WMP’s Oceania Hub, Cam Simmons likens the 27-month randomised control trial in Yogyakarta to baking the perfect cake. The many ingredients of which include engagement with the local community, coordination with a network of primary care clinics, the field work, the mosquito releasing, collecting and monitoring and much more. He explains that all of these things need to be perfectly aligned and executed to achieve the desired outcome. 

“To see the trial deliver in the way that it did,” Professor Simmons says, “was a beautiful icing on the cake.” 

The outcome of the trial was a profound reduction in dengue incidence in the neighbourhoods of Yogyakarta where Wolbachia-carrying mosquitoes were released.  Publication of the results in the New England Journal of Medicine speaks to the significance of the outcome. 

The 77% reduction in dengue incidence and 86% reduction in dengue hospitalisations demonstrated in the trial sets a new precedent for the fight against dengue, a disease that’s been a growing problem throughout the tropical world for over five decades. None of the control measures used in the past have shown anything like this kind of effectiveness.

WMP’s Director of Impact Assessment, Katie Anders has been working on dengue for the past 13 years – she credits the University of Gadjah Mada, the community engagement teams and the Yogyakarta community, for helping build the local support that made the work possible.

“I really think the results of this trial will be a game changer,” Dr Anders says. “There have been a lot of people watching our work over the years – waiting to see the results of this trial. Now that they’re published people don’t need to take our word for it. The data is there that this really works to prevent dengue.”

Since the trial ended, the intervention has been expanded to cover the entire city and neighbouring districts. In 12 months time, 2.5 million people can expect to be benefiting from the protection from dengue that Wolbachia provides. 

Professor Adi Utarini joined the project in Yogyakarta in 2013. While proud of the success of the trial she also knows what the longer term implications mean for her Yogya community.

“In Indonesia, we have been fighting dengue for more than five decades,” she says. “Dengue has always been a serious problem, especially if we look at it from the perspective of society. For a long time, people have always gone into sporadic panic, especially every rainy season. Worse still, this disease mostly strikes children, making the death rate among children relatively high.”
Prof Adi Utarini

From a global perspective, the outcome represents the end of the research phase of the program and the beginning of a new phase – that of implementing the method at scale. For Yogyakarta, it represents renewed hope of a future free from the fear of your child coming home with a fever. 

“A 77% reduction in dengue – after all the intervention programs that have been conducted in Indonesia for over 50 years – is significant,” says Professor Utarini. “It is like the light that shines in the dark, something people here have wished for. It really is some achievement.”

For Cam Simmons, who began his career researching dengue patients from the end of hospital beds in Ho Chi Minh City, it’s an exciting time for disease prevention. He’s seen first hand the devastation dengue and other mosquito-borne diseases can inflict.

“The biggest impact for me every day visiting the paediatric intensive care unit was walking past the families who waited at the door. Waiting to get an update on their child. So for this work to take away that anxiety from a whole sector of the community – who won’t have to sit with their child in a hospital bed – is the greatest reward I think. Taking away that look in a parent’s eye of concern for their child… that’s a huge reward.”
Professor Cam Simmons
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