Breeding crisis

Pakistan is facing a sharp rise in mosquito-borne diseases following the retreat of the monsoon season. According to officials and experts, the country faces a perfect storm of climatic conditions, urbanization, and poor sanitation that has created fertile ground for the spread of dengue, chikungunya, malaria, and the Zika virus. The Punjab government declared a public health emergency in Rawalpindi on October 2 in response to the city’s rising dengue cases. In total, the garrison city has recorded over 1300 cases and at six deaths due to dengue this season. Punjab as a whole has recorded over 1700 dengue cases and at least seven deaths so far this year and it is not the only province grappling with this problem. Of Khyber Pakhtunkhwa’s 904 dengue cases this year, 761 were recorded in September alone and 53 new cases were reported on October 2, raising the threat of a full-blown outbreak. It is not just dengue that is running rampant. Chikungunya is also spreading, with the National Institute of Health (NIH) reporting over 250 cases of chikungunya each week. Health officials believe that the actual number could be up to ten times higher due to the lack of PCR testing.

Then there is the discovery of the Zika virus in Karachi, which is especially dangerous for pregnant women as it can cause severe birth defects like microcephaly. Although cases remain limited, public health officials are urging swift action to prevent Zika from spreading further. The most striking aspect of its outbreak it its link with climatic conditions. Temperatures between 26 and 29 C and humidity levels above 60 per cent have been identified by the Pakistan Meteorological Department (PMD) as ideal for the Aedes aegypti mosquito – the primary carrier of dengue, chikungunya, and Zika. When these climate factors are combined with Pakistan’s poor waste management, open sewers, potholes with stagnant water, lack of sanitation and generally unhygienic conditions; one can see why the country is so vulnerable to mosquito-borne diseases. A woefully inadequate and underfunded health system is also not poised to contain the rise of disease on a long-term basis, with dengue cases nearly doubling year-on-year since 2021.

That being said, Pakistan is not alone in dealing with this problem. The World Health Organization (WHO) reported over 12.3 million dengue cases globally by August 2024. The majority of these cases are likely located in the Global South, where climatic conditions for dengue are more ideal, pollution tends to be higher and health infrastructure weaker. In this context, WHO’s Global Strategic Preparedness, Readiness, and Response Plan (SPRP) calling for a unified global effort to tackle mosquito-borne diseases is a crucial blueprint. Aside from internationally coordinated efforts to strengthen healthcare responses to dengue and similar diseases, there is also an urgent need to look at the poverty, inequality and subpar urban infrastructure that enables such mosquito-borne diseases, and disease in general, to disproportionately impact the developing world. A rapidly warming climate is tied into these issues and is also a problem that has an outsized impact on poorer countries despite their relatively minimal contribution to global warming. The health impact of global warming and the global efforts needed to confront the problem ought to be front and centre at the upcoming COP29 and so should the leaders of the rich countries fuelling this problem.