Dengue Day 2015: Interview With Professor Tikki Pang

From the perspective of a policymaker, implementation and operational research on dengue is far more urgent than basic research, says Professor Tikki Pang.

Professor Tikki Pang
Visiting Professor, Lee Kuan Yew School of Public Policy, National University of Singapore
Former director of Research Policy & Cooperation, World Health Organization

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AsianScientist (Jun. 15, 2015) – Professor Tikki Pang, born in Indonesia and a long-time resident of Malaysia, is an expert on arboviruses and other tropical diseases. During his career as an acaemdic, he served as a professor of biomedical sciences at the University of Malaya and held appointments as a fellow of the Academy of Medicine of Malaysia, the Academy of Sciences for the Developing World (TWAS), the American Academy of Microbiology and the UK’s Institute of Biology, among others.

As the director of Research Policy & Cooperation for the World Health Organization, he focused on encouraging evidence-based health policy development and promoting transparency and accountability in health research. He shares with Asian Scientist Magazine his thoughts on the importance of linking science with policy.

1. What are the key factors driving the increasing incidence of dengue in Asia and beyond?

I would say the key factors are increased urbanization, high population densities and perhaps increased global temperatures due to climate change, although this factor is still uncertain.

Furthermore, control programs have until now relied on vector control strategies, which have not clearly been shown to be always effective to reduce the disease burden. We are in need of new, effective interventions to prevent and control dengue, including vaccination.


2. You were previously the director of WHO’s Research Policy & Cooperation department. From your experience, what is the most urgent need policy makers should address when it comes to dengue?

The most urgent need is to consider a multi-method and integrated approach to dengue control which includes vector control and environmental management, preventive vaccination, and public awareness and education.


3. The WHO struggled to contain the 2014 Ebola outbreak. What were the key lessons learnt and how can they be applied to dengue policy?

The key lessons that were learnt from the 2014-2015 Ebola outbreaks were as follows:

  1. Rapid sharing of accurate information about imminent outbreaks
  2. Strong country capacities for surveillance and response
  3. Effective coordination of international efforts to control the outbreak.

All these apply to future policies for introduction of dengue vaccines, i.e. strong national capacities for surveillance and response which is supported by international agencies.


4. Officials in Singapore have said that Sanofi Pasteur’s CYD-TDV vaccine is “not effective enough” for the country’s needs because of its incomplete protection against serotype 1 and 2. Do you agree with this assessment?

The idea that a vaccine needs to have 90-100 percent efficacy is a myth and there are many vaccines in wide use which have lower efficacies, e.g. influenza vaccines. The key fact to remember is that, despite its lower overall efficacy, the vaccine prevents most severe disease and reduced hospitalizations. ‘The perfect is the enemy of the good’ and are we going to wait another 40 years for a dengue vaccine?


5. Given their limited resources, what should Asia’s developing nations prioritize out of research on vaccines, drug development, vector control, diagnostics and other dengue fighting measures? Which would give policy makers ‘most bang for their buck’?

Without a doubt they should focus on implementation and operational research rather than upstream basic research. From a policy perspective this should be the highest priority in order to ensure effective implementation of a preventive vaccination program.

We need to convene all the key stakeholders to drive these important discussions forward to inform and persuade decision makers. Country leaders must also consider dengue as a regional health issue requiring solidarity among affected countries. Important initiatives include the Dengue Vaccine Initiative and the Partnership for Dengue Control, which are global organizations. In Asia, there are the regional Asian Dengue Vaccination Advocacy meetings to address the practical challenges faced by ASEAN countries for dengue vaccine introduction.


6. What, in your opinion, is the best way to finance urgently needed global health programs?

For me, it would be a balanced mixture of national and external funding which depends on the political commitment and international donors acknowledging the key challenges in global health. At the same time, such financing mechanisms need to be equitable, sustainable and have ownership of the recipient countries.


7. Are public-private partnerships the way forward for dengue prevention? What are the potential benefits and drawbacks?

Dengue prevention is a complex, multi-sectoral and multi-dimensional issue and should be largely a state/public sector responsibility; whilst traditionally; “PPPs” were more narrowly focused on product development. If your question refers to public-private collaborations, such engagements are increasing and must be encouraged, as the private sector has an important role to play in supporting initiatives to prevent major diseases such as dengue.


8. What more can be done to bridge the gap between researchers and policy makers?

More needs to be done to improve trust through dedicated mechanisms and processes where research evidence can be made understandable to policy makers, and where policy makers can frame their priorities in ways which can be addressed by researchers.

This article is part of our feature on ASEAN Dengue Day 2015. Click here to read other articles in the series.

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Copyright: Asian Scientist Magazine; Photo: Tikki Pang.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.

Rebecca did her PhD at the National University of Singapore where she studied how macrophages integrate multiple signals from the toll-like receptor system. She was formerly the editor-in-chief of Asian Scientist Magazine.

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