Quezon city: Improper treatment and late intervention are major drivers of mortality among dengue cases nationwide. At a health forum in Quezon City on Tuesday, Philippine Foundation for Vaccination Director Dr. Lulu Bravo noted that while dengue has been prevalent in the Philippines for 70 years, the medical community still struggles with appropriate case management. "Sa totoo lang po, maraming doktor, hindi pa rin alam mag-manage ng (To be honest, many doctors still do not know how to manage) dengue, period," she said.
According to Philippines News Agency, Bravo highlighted that 80 percent of dengue cases are asymptomatic, while only 20 percent manifest symptoms. Deaths often occur because of failure to recognize the transition from mild symptoms to severe dengue. Patients may experience hypovolemic shock due to late hydration, or conversely, suffer from pulmonary congestion when given too much fluid. "Sumobra na ang tubig sa katawan. At doon po, marami ang namamatay sa dengue. Kailangan talagang pag-aralan po ng mga doktor ang pagma-manage ng appropriate case sa dengue (Fluid overload is a leading cause of death in dengue patients. It is imperative that physicians thoroughly study the appropriate clinical management of dengue cases)," Bravo said.
She emphasized that the one-percent mortality rate among hospitalized patients could be significantly reduced if doctors were better trained in scientific, evidence-based management. PMA Ad Hoc Committee on Dengue Advocacy Chair Dr. Erica Tania Davillo said the Philippines has overtaken its neighbors by a significant margin. Data show the country reached 285,109 cases, nearly double that of second-ranked Vietnam at 168,000. The disparity in fatalities showed that the Philippines recorded 1,132 deaths, while Bangladesh followed with 412. Other countries in the region have reported zero deaths.
Health experts are looking at countries like Sri Lanka as a model for clinical management. PMA Ad Hoc Committee on Dengue Advocacy member Dr. Enrique Tayag said the Philippine Health Insurance Corporation spent PHP3.5 billion on dengue in 2024, yet this only accounted for 30 percent of the country's total direct and indirect costs, which are estimated at PHP11.5 billion annually. "Parang tina-tax tayo ng dengue ng ganong kalaking halaga (It's as if dengue is taxing us of such a massive amount)," he said. Tayag noted that for every 1,000 people infected in the country, four die, whereas other countries have reduced that rate to one in 10,000.
He also emphasized the need for a comprehensive long-term plan to achieve Zero Dengue Deaths by 2030, which is built on five pillars: Surveillance, Clinical Management, Vector Management, Vaccine Development, and Communication and Advocacy. As a leading researcher and vaccine advocate, Bravo appealed to policymakers and the public to embrace immunization as the most effective tool to end the 70-year cycle of the disease. "Based on the years and years of vaccine development, vaccine is the way forward. Because 70 years have proven that no matter what we do, if we don't do a definitive control ... we will never achieve [zero deaths]," Bravo said.
She stressed that while vector control and other measures are part of a comprehensive approach, vaccines are the "most important control measure" for vector-borne diseases. "Please believe it. Vaccine is the most important control measure. It will save lives, and I hope that our policymakers are listening," she added.
