The Guardian (USA)

‘I felt pains all over my body’: Argentina battles dengue outbreak as politician­s pass up vaccine opportunit­y

- Sylvia Colombo in Buenos Aires

On a particular­ly warm autumn afternoon in Buenos Aires, Michelly Natalí Barreto Sánchez, 22, began to feel unwell. As she served customers at La Boca, the bar she had opened in Villa 31, one of the capital’s largest slums, she suddenly started to experience severe headaches and dizziness.

She told her customers, who are among the 70,000 people who live in this densely populated area close to the city centre, that she would have to close the bar, and she headed home.

“It was a matter of hours before I felt pains all over my body,” she says. “My bones hurt. I tried to eat, and everything came back up, and in the following days, I couldn’t even swallow water. I vomited the medication I took and had to hold on to the walls to walk.”

Dengue in Argentina broke a record this year. In the first eight weeks of 2024, authoritie­s reported 57,461 confirmed cases and 47 deaths, a 2,153% increase compared with the same period last year. Recent data from the health ministry indicates a new record was reached in March when cases rose to 233,000 and deaths to 161.

The spike in cases occurred in the same year Argentina registered record temperatur­es, providing the conditions for the Aedes aegypti mosquito to thrive. An as-yet-unpublishe­d report from the National Scientific and Technical Research Council (Conicet) associated with the University of Buenos Aires, two leading Argentine institutio­ns, paints a picture of the current state of the epidemic in the country.

“Our study shows that the thermal favourabil­ity for the mosquito to continue acting for longer has increased and, in this year’s case, has spread among more people,” says Sylvia Fischer, a researcher at Conicet and a coauthor of the forthcomin­g report. “The conditions of large cities, with a large part of the population living in densely populated areas, is another significan­t factor.”

Hospital overcrowdi­ng aggravates the epidemic’s impact on vulnerable people. Natalí Barreto witnessed dreadful scenes when she spent a week at a public hospital. “I waited 11 hours to be seen in a waiting room where people screamed in pain from their bones,” she says. “There are many interns there. They kept missing my vein, and I was reluctant to let them draw my blood any more.”

José Salgado, 31, is a cartonero, a cardboard collector in the city’s rubbish dumps, who contracted dengue haemorrhag­ic fever, a severe form of the disease. “It wasn’t very clear to me how exposed I was until the doctors who treated me later explained. I feel that there aren’t informatio­n campaigns, at least not as there should be, in the densely populated neighbourh­oods,” says Salgado, who lives in Berazatégu­i, a district in the Buenos Aires metropolit­an area.

“Digging through trash, which for many Argentinia­ns is their only job, is highly dangerous amid a dengue epidemic,” says Fischer.

More than 57% of Argentina’s 46 million people live in poverty. A 2022 report from the Ministry of Environmen­t and Sustainabl­e Developmen­t under the Peronist government of Alberto Fernández noted: “In rural population­s and densely populated urban neighbourh­oods, the conditions of temperatur­e, humidity, and water precipitat­ion favour the reproducti­on of the Aedes aegypti mosquito. This risk is especially present in areas of unplanned urban expansion.”

That is the case in Berazatégu­i: children playing football on vacant land punctuated by puddles of water – a breeding ground for mosquitoes – is a common sight.

Environmen­talists point to the government’s responsibi­lity for the high dengue figures. Camila Mercure, responsibl­e for climate policy at the Environmen­t and Natural Resources Foundation, argues that far-right president Javier Milei’s decision to downgrade the environmen­t ministry “does not aid in the formulatio­n of public policies”.

Carlos Regazzoni, a doctor and former Buenos Aires secretary of social developmen­t, says vaccinatio­n would be essential to fight the dengue epidemic. However, although approved by the National Administra­tion of Drugs, Foods and Medical Technology (Anmat), the vaccine is not on the agenda.

The government argues that there is no evidence to prove its efficacy across all age groups and that vaccinatin­g now would not combat the current outbreak, as it would only protect people from future outbreaks.

Only those who can afford to pay private clinics between $150 and $160 (£120 to £127) get vaccinated.

“It would be worrying and frustratin­g if this decision were related to a government’s denialist stance,” says Regazzoni.

When asked about the government’s concern regarding dengue, Milei’s government spokespers­on, Manuel Adorni, said: “Anything that kills human beings is a concern for the government, including car accidents.”

On ruling out the inclusion of the dengue vaccine in the country’s vaccinatio­n schedule in March, Adorni told a press conference: “Immunity is obtained with time, so by vaccinatin­g now, that immunity will only be obtained in

four months, when the mosquito is no longer an inconvenie­nce, and the effectiven­ess has not been proven.”

The president’s statements on the climate crisis reinforce the suspicion of vaccine denialism on the part of the Milei government. Milei has said that Argentina would not continue with the Paris Agreement and that global heating was a cyclical issue that would eventually pass.

Milei’s administra­tion has made no secret of its contempt for environmen­tal matters, and the president called the climate crisis a ‘“socialist lie”, and reduced the health ministry’s budget by 40%.

On 2 April, the health ministry published a note on X that questioned the vaccine’s efficacy, saying it would wait for “more scientific evidence” before offering it to the public. “The vaccine is not a validated tool for controllin­g the transmissi­on of the disease in the context of the outbreak, as expressed by the Pan American Health Organizati­on”, the note said.

Mercure says the far-right government doesn’t appear to care about the climate crisis or its consequenc­es, such as the dengue fever outbreak. “The government seems to act as if it doesn’t acknowledg­e global warnings and doesn’t respect internatio­nal commitment­s to mitigate the effects of climate change,” she says.

One consequenc­e of this lack of interest is that stocks of mosquito repellants in Buenos Aires are not meeting demand. “My main issue with the government is not just the lack of public policies to combat dengue but also this shortage of repellants, which could be mitigated by government purchases and distributi­on to the public,” Fischer says.

Meanwhile, in Villa 31, Natalí Barreto has reopened her bar. “I lost money from being sick for almost a month,” she says as we walk through the potholed streets. “But I’ll stock up on repellant when available.”

I waited 11 hours to be seen in a waiting room where people screamed in pain from their bones

Michelly Natalí Barreto Sánchez

 ?? Photograph: The Guardian ?? Closely packed houses in Villa 31, one of the largest slums in Buenos Aires.
Photograph: The Guardian Closely packed houses in Villa 31, one of the largest slums in Buenos Aires.
 ?? Photograph: Tomás Cuesta/The Guardian ?? Michelly Natalí Barreto Sánchez, who contracted dengue fever, on a rooftop in Villa 31.
Photograph: Tomás Cuesta/The Guardian Michelly Natalí Barreto Sánchez, who contracted dengue fever, on a rooftop in Villa 31.

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