Project Description
Scaling Health Interventions for Effective Long-term Dengue Control (SHIELD): Implementation and policy research for scaling up Wolbachia in Indonesia
Summary
SHIELD addresses the challenges of scaling and integrating Wolbachia replacement technology, a proven method for controlling dengue and other arboviral diseases, into national dengue control programmes. With Indonesia facing one of the highest dengue burdens in the world, the programme aims to increase the reach and impact of Wolbachia-based dengue control in Indonesia and to generate insights for broader global adoption.
people threatened by dengue worldwide
estimated global cost of dengue each year
dengue cases and 11,000 deaths reported globally in 2024, a record
hospitalised dengue cases and 1,461 deaths in Indonesia, 2024
The challenge
Conventional measures such as insecticide fogging have failed to curb surging dengue transmission, which is driven by urbanisation, climate change and global mobility. New tools, including Wolbachia and Takeda’s QDENGA® vaccine, offer new hope, and there is an urgent need to accelerate their uptake into disease control programmes.
Wolbachia
Wolbachia is a naturally occurring bacterium. When introduced into Aedes aegypti mosquitoes, it reduces their ability to transmit dengue and other arboviruses. Trials by our team, including the pivotal efficacy study in Yogyakarta, showed significant and sustained reductions in dengue incidence after Wolbachia releases.
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2017–2020
Pivotal efficacy trial in Yogyakarta
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2021–2025
National Dengue Control Strategy names Wolbachia a key innovation
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2022–2025
Ministry of Health pilots programmatic delivery in five cities
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SHIELD
Lessons from the 5 Cities Project for national and global scale-up
OVERARCHING GOAL
To derive lessons from Indonesia’s 5 Cities Project, a pilot Wolbachia implementation initiative, to inform strategies for national and global scale-up.
SHIELD builds on our team’s decade-long translational research collaboration to bridge the evidence-to-action gap and maximise the reach and impact of new tools against epidemic arboviral disease.
Specific objectives
Evaluate Deployment Feasibility
Evaluate the feasibility, acceptability and effectiveness of Wolbachia deployment under programmatic conditions.
Identify Scaling Adaptations
Identify critical intervention components and the adaptations required to maintain effectiveness during scaling.
Assess Long-Term Outcomes
Address knowledge gaps on long-term entomological and epidemiological outcomes.
Co-design Operational Models
Engage stakeholders in co-design of sustainable and scalable operational models.
Inform Integrated Dengue Control
Inform strategic decisions on integrating Wolbachia and vaccination into dengue control in Indonesia.
Support Global Policy and Practice
Leverage Indonesia’s experience to inform global policy and practice for arboviral disease control.
Four interrelated work packages (WP)
Implementation research
Systematic assessment of resources, capabilities, barriers and enablers for effective scale-up of Wolbachia.
Entomological studies
Operational and ecological factors affecting Wolbachia establishment, and the field resilience of the intervention to heatwave conditions.
Public health impact
Dengue case reductions from routine surveillance and prospective clinic-based studies, with seroprevalence surveys to guide Wolbachia and vaccine targeting.
Economic and disease modelling
Cost-benefit and budget impact of Wolbachia under programmatic conditions, and optimal integration with dengue vaccination campaigns.
Expected impact
In Indonesia
A feasible and effective model for scaling up Wolbachia, contributing to the national goal of building innovations into evidence-based policy and practice, and supporting nationwide scale-up to reduce dengue illness and deaths.
Globally
Critical evidence for decision-making and operational planning on integrated arboviral disease control, including cost-effective and equitable targeting of Wolbachia and vaccination programmes.
Funding
Collaborators
