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Irregularities, mismanagement fueled Dengue outbreak: Call to formulate a national strategy

Lack of national work plan to counter emergencies ignoring potential risk of spread of Aedes mosquito and widespread irregularities in controlling initiatives fueled horrifying Dengue outbreak this year in Bangladesh, which caused the ailment of several thousand and nearly two hundred deaths from the mosquito-borne disease, observed TI Bangladesh. 
Unveiling a rapid research study which was done considering the dengue situation an emergency health hazard, the anti-graft organization also stated that organizational shortcomings and lack of coordination among the organizations concerned in the mosquito eradication program worsened the dengue situation across the country although there are mechanisms in place to ensure a healthy environment. Calling for robust accountability sparing no one involved, TI Bangladesh also placed 15 points recommendation to the authorities concerned for controlling Aedes mosquitoes.
To unveil the study titled `Aedes Mosquito Control in Dhaka City: Governance Challenges and Way Forward’, TI Bangladesh organized a press conference on 25 September 2019 at its Dhaka office.TI Bangladesh Executive Director Dr. Iftekharuzzaman and Executive Management Adviser Professor Dr. Sumaiya Khair, Director-Research & Policy (R&P) Mohammad Rafiqul Hassan attended the event. TI Bangladesh Deputy Programme Managers of R&P Md. Julkarnayeen and Mostofa Kamal presented the research findings at the event accompanied by the research coordinator Shahzada M Akram, Senior Programme Manager-R&P.
Dr. Iftekharuzzaman said, “Although there were dengue outbreaks in Bangladesh in the last few years, adequate importance was not provided to control it at any level. The mindset of concerned authorities ignoring the dengue prediction and the lack of preparation and strategies to take preventive measures caused the overall situation to spiral out of control.” There had been no coordinated plan or actions to control Aedes mosquito, Dr. Zaman said, adding that relatively ineffective pesticides were used to show off to the country's people.
The study was based on secondary resources and focused on finding out the sort of irregularities and corruption were prevalent, and what was barring the country in tackling the situation. It also tried to focus on measures that could be taken to get the situation under control. Conducted between August 20 and September 20, 2019, in the wake of severe dengue outbreak in the country, information about the last five years' (2015-2019) mosquito control activities were also taken into consideration for the study.
According to the report, Aedes mosquitoes need to be controlled via environment management, organic management, with a mechanical method, and by applying chemicals. But the two city corporations opted only for the chemical option. Dr. Zaman said, “even though applying larvicide and destroying the source of mosquitoes proved effective, both the city corporations were conducting anti-mosquito drives with an adulticide, as chances of irregularities were higher in purchasing the adulticide. People’s attention is easily drawn during the application of adulticide, which is another reason for giving more importance to it, Dr. Zaman added. 
The study identified that the Dhaka North City Corporation (DNCC) and the Dhaka South City Corporation (DSCC) adopted unplanned and uncoordinated efforts to fight the menace of Aedes mosquito, which paved the way for irregularities in every step. It said that the authorities made mistakes in anticipating massive Aedes mosquito breeding and paid no heed to the warnings given by the ICDDR, B and the Disease Control Wing of the Health Services. The authorities also paid no attention to the warnings that the application of ineffective adulticide was in use to control the dengue virus carriers. The city corporations took no plans to control mosquitoes from the environmental angle but only used ineffective adulticides to fumigate the roads. Adulticide application was less effective than larvicide but the city corporations were more interested in procurements to misuse funds, according to the study.
 The study also found that the necessary government rules were not followed properly in buying insecticides. Dhaka South City Corporation (DSCC) bought insecticides from a company that was blacklisted by Dhaka North City Corporation (DNCC). The DSCC lost 40 per cent of its money spent on insecticides in 2018-2019. DSCC bought insecticide for Tk 378 a litre from Narayanganj Dockyard and Engineering Works Ltd. Agro products Ltd, which supplied the insecticide to the company, offered DNCC Tk 217 per litre, which means the DSCC lost Tk 161 per litre by buying from a third party, found the study. The study also found in many cases, insecticides and fuel of fogger machines were sold and larvicide was discarded. The field-level workers also took Tk 50 to Tk 200 to apply adulticide at garages or on ground floors of buildings, the report said.
Referring to a lack of coordination and poor information sharing of relevant stakeholders, Dr. Zaman said, “Corruption took place in every step of pesticide purchase. Black-listed organizations were awarded work orders following no procurement rules whereas they also didn’t qualify to carry out the works. Illegal transactions were made at all levels from approval of bills to supply of goods. As a result, there has been a huge waste of state money. In one case, nearly 40% of the purchasing cost was spent on bribery and corruption.” Acknowledging the dengue problem as a problem for a long time, Dr. Zaman called upon the government to formulate a national strategy. Dr. Zaman also underscored the need for adopting short-, medium- and long-term plans to combat the mosquito menace. Observing on the allocation of budget in controlling the Aedes mosquitoes, Dr. Zaman said, “I don’t find the allocated budget insufficient. A sufficient amount of money was allocated from the budget,  more could have been allocated if needed, however, we have identified that irregularities in one hand, and lack of skills on the other hand in making fair use of the money. Only the Government’s goodwill can bring the involved under accountability, through which significant progress can be made in tackling such challenges.” Concluded Dr. Zaman. 
At the press conference, TIB put 15 points of recommendations to strengthen the challenges in controlling Aedes mosquitoes in Dhaka city including among others, coordinated activity by the city corporation’s authorities involving relevant stakeholders; locating hotspots of Aedes breeding in the city before the outbreak; develop concentrated database of all the government and private hospitals, diagnostic centres in Dhaka with easy access for everyone; sufficient recruitment of human resource for the field level followed by assessing requirements; capacity building of the human resources; establishing transparency and accountability in operations and management of city corporations etc. Also, the existing laws have to be amended, and real estate companies and government and private organizations need to be instructed on what to do about controlling mosquitoes. There must be a provision for punishing those who fail to comply. Furthermore, The city corporations will have to identify hot spots of Aedes mosquitoes each year after conducting surveys with the help of the Directorate General of Health Services and icddr,b. Necessary steps will have to be taken immediately based on the survey findings. Moreover, surveys on Aedes mosquitoes have to be carried out outside Dhaka as well. The authorities concerned may take the help of local universities, entomologists and private research organizations.