Nearly three decades after Bangladesh's first major dengue outbreak, the mosquito-borne disease still remains one of the country's most persistent public health concerns. Despite spending hundreds of crores of Taka on mosquito-control programmes, healthcare services, public awareness campaigns and technological interventions, two city corporation authorities "DNCC and DSCC-have barely failed to contain the dengue menace.
What began as a largely seasonal problem concentrated in the capital has now evolved into a nationwide challenge, affecting both urban and rural communities unabated.
Every monsoon, hospitals across the country face a surge in dengue patients, raising renewed concerns about the healthcare system's ability to manage such outbreaks.
Health experts say the failure to curb dengue cannot be attributed to a lack of funding; instead, they point to weaknesses in planning, implementation, inter-agency coordination; and community participation.
According to official data, Bangladesh recorded its deadliest dengue outbreak in 2023, when 1,705 people died. Although fatalities fell to 575 in 2024 and 413 in 2025, experts warn that the situation remains far from under control. They note that lower death tolls do not necessarily reflect success, as dengue has continued to spread beyond the capital into districts and rural areas, making disease management increasingly complex.
The economic burden is considerable. Public health officials estimate that treating a dengue patient in a government hospital can cost up to Tk50,000. In 2023 only, the government reportedly spent more than Tk400 crore on dengue treatment and related healthcare services.
Spending on mosquito control has also risen sharply, with data from Dhaka North City Corporation (DNCC) and Dhaka South City Corporation (DSCC) showing nearly Tk830 crore has been spent on mosquito-control activities over the past decade. DNCC accounted for approximately Tk560 crore, while DSCC spent around Tk270 crore.
For the current fiscal year-FY26, the two city corporations allocated more than Tk154 crore for anti-mosquito operations.
Both DNCC and DSCC have introduced a range of measures, including insecticide spraying, drone-assisted identification of mosquito breeding sites, the removal of discarded tyres and containers, and public awareness campaigns. However, many residents say the efforts have brought little visible improvement.
"We regularly see mosquito-control activities in our area, but the situation hardly changes," said Akash Hossain, a resident of Maghbazar in the capital. "Within a short time after spraying, mosquitoes return in large numbers."
Dr Nishat Parveen, deputy chief health officer of DNCC, said one of the major weaknesses is the concentration of dengue-control efforts in the capital.
"Many municipalities and local government institutions outside Dhaka do not have the same level of preparedness or intervention capacity," she said. "As a result, dengue transmission is expanding rapidly in other parts of the country."
She also highlighted the challenge of eliminating breeding sites located within private properties.
Experts identify flower pots, rooftop water tanks, air-conditioner trays, construction sites and discarded containers as some of the most common breeding grounds for Aedes mosquitoes.
Healthcare preparedness has also come under scrutiny. During a recent high-level meeting at the Ministry of Health, officials reportedly struggled to provide accurate information on saline supplies and other essential medical resources available at field-level facilities.
Professor Dr Monir-Uz-Zaman, convener of the Society of Medicine, believes frequent transfers of trained healthcare workers have weakened the country's dengue response.
"Healthcare professionals who receive specialised dengue training are often transferred elsewhere, while less experienced personnel are assigned to manage patients," he said.
Research into dengue-related deaths during the 2023 outbreak revealed significant shortcomings in patient care. Only 35 per cent of patients received fluid management in accordance with national treatment guidelines, while deficiencies were also identified in patient monitoring and clinical decision-making.
Public health expert Dr Tarekul Islam Limon said dengue could no longer be viewed as a seasonal disease.
"Extended monsoon periods, rising temperatures and increased humidity are creating favourable conditions for Aedes mosquitoes throughout much of the year," he said.
He added that mosquito breeding patterns were changing, with Aedes mosquitoes increasingly adapting to environments previously considered unsuitable.
Dr Limon also criticised what he described as poorly planned mosquito-control operations, arguing that authorities often conduct widespread insecticide spraying without scientifically identifying mosquito hotspots.
Renowned physician and Emeritus Professor Dr A.B.M. Abdullah believes public participation remains one of the most important elements of dengue prevention.
"There is no universally available vaccine capable of protecting the entire population," he said.
"Prevention remains our most effective weapon."
He urged citizens to eliminate stagnant water around their homes and take greater responsibility for preventing mosquito breeding.
Entomologist Dr Kabirul Bashar said traditional seasonal campaigns were no longer sufficient.
"Dengue control requires year-round surveillance, scientific planning and evidence-based interventions," he added.
According to experts, dengue is no longer solely a healthcare issue but a complex challenge involving urban management, environmental protection, climate change and public behaviour. Without sustained action, they warn, the country is likely to remain trapped in a costly cycle of its recurring.
