Denny Armandhanu and Neo Chai Chin, Jakarta/Singapore – If researchers and the authorities had their way, millions of mosquitoes infected with naturally occurring bacteria would now be buzzing around in Bali, helping to fight the spread of dengue fever during the ongoing rainy season.
Earlier in the year, the World Mosquito Programme and its partners had made their rounds in Denpasar and Buleleng, the two sites in Bali where they had planned to release the mosquitoes carrying the Wolbachia bacteria.
More than 10,000 households had agreed to host mosquito-release containers on their property, and nearly 500 health workers had tried to publicise the project to the community, according to the World Mosquito Programme's website.
But protests and the spread of falsehoods disrupted the plan.
On social media, false claims circulated about the mosquitoes transmitting Japanese encephalitis (a mosquito-borne virus that can cause severe illness) and "LGBT genes", as well as being part of philanthropist and Microsoft co-founder Bill Gates "depopulation plan".
The protests led the programme – which was due to kick off last month – to be postponed.
But its roll-out at other sites in Indonesia – which were chosen for their high dengue case rates – will proceed, Indonesia's health ministry told CNA.
"In Bandung and Jakarta, we will continue. We will start with socialisation to the community because they did not get the right information," said ministry spokesperson Siti Nadia Tarmizi, referring to the sites slated for next year.
"In Bontang, Kupang, Semarang, everything will continue without any delays," she said, referring to the three sites where the programme began this year.
The release in Bali is now planned for next year, said the World Mosquito Programme, which is supported by the Bill and Melinda Gates Foundation.
'On whose behalf are the refusals?'
Questioning who was behind the falsehoods, Ms Siti said: "On whose behalf are the refusals? On behalf of which communities? The local government did not give any rejection."
The release of Wolbachia mosquitoes is "not something extraordinary", she said.
"It is the same as if we, for example, intervene (against a disease) by giving certain drugs in a government programme," she added.
"The government is not careless and has conducted studies involving experts" for the Wolbachia programme, Ms Siti said.
The Wolbachia method has been studied in Yogyakarta since 2011, and releases began in 2014. The programme ended last year, after seeing a 77 per cent reduction in dengue fever cases and an 86 per cent drop in hospitalisations, and no deaths from the disease.
From over 1,700 dengue cases in Yogyakarta in 2016, the number has plunged to 67 this year up until mid-November, according to Dr Lana Unwanah, head of disease prevention and control at Yogyakarta Health Office.
The drop is due to the Wolbachia programme as well as other mosquito eradication methods, she said at an event at Gadjah Mada University.
Facts about dengue and wolbachia
Dengue, which is transmitted by the Aedes aegypti mosquito, has been ranked as the "most important mosquito-borne viral disease in the world". Cases have dramatically increased worldwide. Symptoms can be mild, but the disease can also be deadly.
Indonesia's health ministry reported 143,000 cases of dengue fever last year, or around 52 cases for every 100,000 people. It recorded 1,236 dengue deaths, mostly among children aged below 14 years.
Countries that have deployed Wolbachia technology include Singapore and Malaysia. Singapore launched Project Wolbachia in 2016 and has released over 300 million male Wolbachia mosquitoes, while Malaysia chose its first locality for a pilot study in 2017.
Wolbachia is a type of natural bacteria that occurs in about 60 per cent of insect species, but doesn't normally occur in Aedes aegypti mosquitoes.
When the mosquitoes are infected with Wolbachia, viruses like dengue, chikungunya and Zika are blocked from growing in their bodies. This means the Wolbachia mosquitoes have less ability to transmit viruses to people. They are not genetically modified, as no changes have been made to their genetic material.
'Systematic disinformation' seen
Asked how the Wolbachia programme could have invited protests and been postponed after 10,000 households agreed to participate, Dr Riris Andono Ahmad, a researcher at the Gadjah Mada University's Centre for Tropical Medicine, said Indonesian society is "very communal" and prioritises harmony.
"Individual decision is not the main thing; the main thing is collective decision," he explained. "If there are one or two people who refuse, it will not be a problem. But if there is one figure who is vocal, able to create a narrative and mobilise the masses, it will be a problem."
Researchers experienced resistance in Yogyakarta to the Wolbachia programme too. "During the research phase in Jogja, 95 per cent of the population was willing to participate," he said, using the Javan city's informal name.
With "a few" creating and spreading "disinformation narratives", it took about a month to convince the community, recalled Dr Riris, who was part of the university's collaboration with the World Mosquito Programme until 2022, and is now researching the long-term impact of Wolbachia in Yogyakarta.
Overall, the Yogyakarta experience showed "people are actually quite open to technology and willing to accept it. They become resistant when people scare them with disinformation", he said.
What stood out most from the resistance in Bali, was the "systematic disinformation", said Dr Riris.
"Fear is spread by disinformation that creates horror, such as of bionic mosquitoes, causing brain inflammation, or the Bill Gates conspiracy, all based on false information."
Bali postponement an opportunity
But the Bali postponement can be a "blessing in disguise", said Dr Riris.
"With this crisis, the public's attention and curiosity towards this technology is greater. If we can manage it well and not be defensive, providing information openly, it will be a good opportunity to inform the public about this technology," he said.
The World Mosquito Programme said the decision to delay reflects the "commitment to listening to communities and provides us the opportunity to address any concerns or questions" about its Wolbachia method.
After news of the Bali postponement on Nov 17, scientists and officials appear to have stepped up information and outreach efforts.
Gadjah Mada University put out articles about the Yogyakarta project's results and about Wolbachia, such as the fact that it does not infect humans.
Bali's Udayana University also held a seminar on Nov 30 on implementing the Wolbachia method on the island.
Public education will continue, said Ms Siti of the health ministry.
Officials and partners will go directly to the communities where the Wolbachia mosquito eggs will be deposited, she said.
They will explain that the hatched Wolbachia mosquitoes will gradually replace those carrying dengue, reducing transmission of the virus. Release will take six months, and it will take two to three years for the intervention to take effect, she explained.
"If 60 per cent of the mosquito population has Wolbachia, then the mosquito community has naturally changed. If less than that, more Wolbachia mosquitoes will be released," Ms Siti said. – CNA/cc(kb)
Source: https://www.channelnewsasia.com/asia/indonesia-dengue-wolbachia-bali-397509