DENGUE AND THE POLITICS OF HEALTH CARE IN VENEZUELA

UNCLAS CARACAS 000198

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NSC FOR CBARTON
USAID DCHA/OTI FOR RUSSELL PORTER

E.O. 12958: N/A
TAGS: SOCI ECON PGOV VE
SUBJECT: DENGUE AND THE POLITICS OF HEALTH CARE IN VENEZUELA

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SUMMARY
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1. (SBU) A significant increase in the number of dengue
cases in Caracas in December sparked concern about an
epidemic among city residents (including the Embassy
community). The upsurge in dengue, following shortly after
an October 2003 outbreak of yellow fever, triggered questions
about the GOV's public health capabilities. Ministry of
Health officials admitted to the existence of a dengue
"epidemic", but have downplayed the threat to public health.
An opposition oriented epidemiological NGO claims Ministry
assessments are politically rather than medically based and
warns that outbreaks of yellow fever pose even more danger to
the public health than dengue. The World Health Organization
(WHO) representative in Venezuela was not alarmed by the rise
in dengue cases but expressed concern about other public
health issues including yellow fever, maternal mortality, and
HIV/AIDS. He praised the GOV's new "Into the Slums" program,
which places Cuban doctors in low-income neighborhoods, as a
step in the right direction. END SUMMARY.

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DENGUE AT EPIDEMIC LEVELS?
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2. (SBU) Dengue is a viral disease which is transmitted by
infected Aedes Aegypti mosquitoes and usually results in a
period of high fever and muscular pain in its victims. Less
commonly, the hemorrhagic form of dengue can result in death.
There are no vaccines against the 4 types of dengue and
incidence of the disease in Venezuela typically rises
seasonally, depending on the amount of rainfall. Ministry of
Health Director of Epidemiology Jose Mendoza blamed unusually
heavy rains in the last few weeks of the year for almost
doubling the number of cases reported in the capital city in
2003 compared to 2002. This rapid increase in the number of
dengue cases allows the use of the word "epidemic".


3. (SBU) According to figures published weekly by the
Ministry, there were 2,666 dengue cases reported in Caracas
by week 49 (November 30 - December 6) of 2003. Only 1,420
cases had been reported by the same week in 2002. National
figures, however, showed 23,916 cases up to the first week of
December 2003, compared to 36,658 cases in the same period of

2002. Countrywide there were 1,999 reported cases of
hemorrhagic dengue which resulted in five deaths in 2003,
three of them in Caracas. Although he acknowledged the
existence of an "epidemic" in Caracas, Mendoza pointed to the
year-on-year 34 percent decrease in national cases as proof
that the Ministry was successfully working against the
disease.

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FROM INADEQUATE INSTITUTIONS TO INCREASED VIRUSES
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4. (SBU) Marisela Perdomo, President of an epidemiological
NGO FUNDEPI, attributed the recent increase in dengue cases
to Venezuela's failing health care infrastructure in a
December 19 meeting with emboffs. The NGO, founded in 1993
with the help of the Ministry of Health, currently has nine
independent epidemiologists affiliated with it. Although
FUNDEPI maintains a close relationship with the M1G