Dengue’s hidden bill: Counting the true cost of inaction
Dengue is no longer just a seasonal health crisis — it is an economic emergency draining billions from households and the nation. Prevention, not treatment, holds the key to breaking the cycle
When Sir Ronald Ross discovered in 1897 that mosquitoes transmit malaria, he exposed a truth that still haunts us: tiny insects can cripple nations. More than 125 years later, Bangladesh is not battling malaria as much as it is battling dengue — the fastest-spreading mosquito-borne disease in the world.
And while headlines focus on case numbers and deaths, what often remains invisible is dengue's economic toll, which is devastating households, straining hospitals, and draining the economy.
Globally, dengue has become one of the costliest public health challenges. In 2013, the annual worldwide cost of dengue illness was estimated at nearly $9 billion. By 2022, the cumulative reported cost had ballooned to almost $95 billion.
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Even this figure is an underestimation, as many cases go unreported. What stands out is how little of this money is spent on prevention; the vast majority goes into treatment and post-outbreak recovery. In other words, the world is footing a mounting bill for neglecting investment in mosquito control.
The story is no different in Bangladesh. A 2019 study in Dhaka revealed the crushing burden dengue places on households and the health system. The average cost per patient was around Tk34,000, but treatment in a private hospital could exceed Tk47,000. Public hospitals were less costly for families — about Tk22,000 — but still imposed heavy expenses.
On top of that, hospitals themselves spent an additional Tk6,000 per patient. Adding it all up, the societal cost of a single dengue episode reached nearly Tk40,000, or about $479.
For poor households, this is catastrophic. Families in the lowest income brackets spent as much as 139% of their monthly income just to treat one case of dengue. To cope, they borrowed money, sold assets, or cut back on essentials such as food and education. The economic cost, therefore, extends far beyond the health sector — it spills into every aspect of life, perpetuating poverty and eroding resilience.
Zooming out, the national implications are alarming. Dengue not only overwhelms hospitals and reduces productivity, but it also undermines economic growth. Malaria once showed how mosquito-borne diseases could cut GDP by up to 3% a year in endemic countries. Dengue is now replicating that pattern in urban centres like Dhaka, where uncontrolled outbreaks are eating away at household savings and national prosperity alike.
The tragedy is that these costs are avoidable. Every taka spent on prevention could save multiple takas in treatment and lost income. Yet Bangladesh, like many countries, continues to pour far more resources into responding to outbreaks than into preventing them. The result is a cycle of annual panic: hospitals overflow, families empty their pockets, and the root causes remain unaddressed.
Lessons from abroad make the economic argument even clearer. Kolkata's ward-based rapid response system and Singapore's long-term environmental management have both shown that sustained investment in prevention pays dividends. By reducing cases, these cities have cut hospitalisation costs, avoided productivity losses, and prevented households from slipping into poverty. Their examples prove that spending on prevention is not just sound health policy — it is sound economic strategy.
Bangladesh must therefore treat dengue not only as a health emergency but also as an economic one. Declaring dengue a reportable disease from 2025 is a welcome step, but it must be matched with serious budget allocations. Vector control programmes need steady funding, entomologists and rapid response teams must be empowered, and community engagement has to move beyond slogans.
At the same time, social protection schemes should shield poor households from the catastrophic health spending dengue imposes. Families cannot be expected to finance the state's failure to control a mosquito-borne disease.
The economic case is clear: billions are being drained each year in treatment costs, while relatively modest investments in prevention could save both lives and livelihoods. This is why dengue must enter the national budget discourse — not as a seasonal line item but as a priority investment in growth and poverty reduction. Just as unchecked malaria once held back entire economies, unchecked dengue now threatens to do the same in our cities.
The WHO's goal of zero dengue fatalities by 2030 is important, but Bangladesh must go further. The real measure of success will not only be lives saved, but also whether families are spared the indignity of being pushed into debt or poverty because of a mosquito bite. Investing in prevention is not charity — it is economic common sense. For a healthier, more prosperous Bangladesh, the cost of inaction is one bill we simply cannot afford to pay.
Moumita A Mallick and Sharika Sabha are both Master's students at the Department of Economics, East West University.
Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.
