Workshop 2 | The Lancet Commission on Arboviral Diseases: Cities without Aedes

Our aim is to finalize a global strategy for eliminating Aedes mosquito-transmitted diseases (ATVDs) from the world’s towns and cities. This collaboration between experts from the health and built environment, including individuals from the World Health Organisation and UN-Habitat, is a multisectoral approach that considers the Ethical, Legal and Social aspects of this intervention.

The focus of the 3-day workshop will be to discuss and finalize a report focused on (1) strengthening new and existing mosquito control tools and vector surveillance in combination with vaccines for immediate short-term disease and vector control while advocating for (2) improved design, construction and management of modern urban environments. Building Aedes out of cities and towns for sustainable improvement in public health must be a multi-disciplinary approach led by city leaders working with local communities. Workshop participants will include individuals with backgrounds in clinical care, public health, epidemiology, entomology, therapeutics and diagnostics, urban planning for sustainable and resilient cities, and social sciences.

Health is increasingly an urban planning issue. Today, 55% of the global population lives in cities. By 2050, the urban population will have doubled with nearly 70% living in cities. By 2030, over 700 million people in Africa will be living in cities. The extraordinary and unprecedented expansion of cities, particularly in low to middle income countries in the tropics and subtropics, require urgent attention: the convergence of high human population densities in economic hubs creates concentrations of susceptible humans living in conditions that facilitate pathogen introduction, persistence and spread. Rapid unplanned urbanisation and societal inequities have resulted in urban slums, home to an estimated 828 million people. This means one third of the global urban population lives in crowded environments with economic deprivation, lack of access to clean water, mosquito-proof water storage systems, sewage disposal, and solid waste management, thereby creating myriad sites receptive to pathogen transmission. Complicating the situation further, increased global travel and trade fuel rapid and long distance spread from one urban center to another.

These trends threaten the world with Aedes-transmitted disease pandemics of dengue, chikungunya, yellow fever, Zika and, in the future, new human viruses. Climate change amplifies this threat by increasing the duration of the annual transmission seasons and modifying precipitation patterns, opening up new areas for mosquito and virus invasion and spread. The triad of urbanization, globalization and climate change has particularly led to the expansion of Aedes mosquitoes, resulting in dengue and other Aedes-transmitted viral diseases becoming a growing threat to the health and development of tropical urban environments, requiring the development and implementation of new approaches for disease and Aedes mosquito control.

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