A growing threat to the health of Americans gained momentum this summer as mosquito-borne viruses began appearing with alarming frequency in the United States.
The Centers for Disease Control issued a health advisory for increased risk of dengue infections in the U.S. in June. In August, a New Hampshire man died after contracting Eastern equine encephalitis from a mosquito bite, and cases of the mosquito-borne West Nile virus - including the hospitalization of infectious diseases expert Dr. Anthony Fauci - increased in parts of the country.
This year has already seen the highest incidence of the mosquito-borne dengue virus globally, according to the CDC, putting hundreds of millions at risk of infection. Dengue symptoms can include high fever, body aches, vomiting, rash and bleeding gums and nose. In severe cases, dengue can be fatal.
What can be done to slow the spread of the world's most common mosquito-borne illness, already endemic in more than 100 countries across Asia, Africa and the Americas?
A new book, "Defeating Dengue: A Multistakeholder Approach to Problem Solving," published by Columbia University Press, has an answer that holds the potential to mitigate the spread of the virus globally in the years to come.
R. Edward Freeman, a professor in the University of Virginia's Darden School of Business, and Andrew Sell, a former senior researcher in Darden's Institute for Business in Society, co-wrote "Defeating Dengue," which tells the remarkable story of how an unlikely group of stakeholders combined expertise, innovation and determination to reduce the incidences of dengue infections in an Indonesian community by 77%.
"Dengue virus threatens the health of Americans and people worldwide," Freeman said. "But it can be stopped. This is a story of how one community proved it by building a trusting partnership of stakeholders that enabled an imaginative solution to a problem that has vexed them for generations."
At the heart of the solution is a novel approach so counterintuitive it seemed impossible - infecting mosquitos with the bacteria called "Wolbachia," rendering dengue and other viruses ineffective, then releasing those insects into communities to reproduce relatively harmless mosquitos.
Wolbachia's superpower was already scientifically established, but figuring out how to test it on a small scale to fight dengue and explore the feasibility of deploying it in larger settings and potentially expand it to major population centers, was far more than a lab experiment.
R. Edward Freeman, a professor in UVA's Darden School of Business, co-authored the new book. (Contributed photo)
Traditional approaches to slowing dengue have focused on reducing the mosquito population by spraying to kill adults or preventing their eggs from hatching and by removing standing water where mosquitos lay eggs. Even the idea of suggesting more mosquitos could slow the spread of dengue produced understandable skepticism, opposition and anger in the Indonesian communities where the pilot project was proposed.
Addressing and overcoming that logical opposition and building a coalition to plan and execute a strategy that included logistics, communication and education, phased implementation, funding, learning from setbacks, and more are what makes Freeman and Sells's book as much a business book as a public health story.
Knowing Wolbachia worked was just the beginning.
"The dengue effort in Indonesia perfectly represents the value of the stakeholder approach to solving problems," Freeman said. "It also illustrates the power of venture philanthropy and the potential for businesses to play critical roles in improving their communities."
The stakeholder approach - a signature philosophy that permeates a Darden education and was articulated in a business context by Freeman four decades ago - holds that businesses work best when they value more than just shareholders. Rather, they consider the business's effect on all stakeholders: employees, suppliers, customers, local residents, institutions and others. The new book also illustrates how this approach can be used to address community and social problems.
Learn more about "Defeating Dengue" on The Darden Report.
