The Sri Lanka Red Cross Society launches the first simplified EAP to combat dengue

The Sri Lanka Red Cross Society has launched the Red Cross Red Crescent Movement’s first simplified early action protocol (EAP) for dengue, marking a milestone for anticipatory action for public health. Validated by the International Federation of Red Cross and Red Crescent Societies (IFRC), this enables the Sri Lanka Red Cross Society to take anticipatory actions that mitigate the impacts of dengue outbreaks in high-risk areas across the country.

“This marks a significant step forward in applying anticipatory action to dengue preparedness,” said Dr Mahesh Gunasekara, director general of the Sri Lanka Red Cross Society. “By activating interventions based on rainfall forecasts and weekly case data, we can [act] before outbreaks escalate, empowering our volunteers and branches to take timely, community-level action guided by evidence-based triggers.”

Targeted actions in high-risk areas

Sri Lanka has faced recurrent dengue outbreaks since the 1960s and it remains endemic, with cases reported throughout the year and spikes seen during monsoon seasons. In 2024 alone, over 89,000 suspected cases were recorded – a substantial increase from 2023 – driven by high rainfall, inadequate waste management and densely populated urban areas.

The simplified EAP is designed to provide support across five high-risk districts: Colombo, Gampaha and Kalutara, which are all in Western Provine, and Kandy and Jaffna, to which dengue can spread due to people moving across the country. It uses real-time climate and epidemiological data to guide the anticipatory actions, with two specific trigger mechanisms:

• First trigger: this is activated when rainfall forecasts from the Department of Meteorology exceed 100mm in the Western Province – conditions that often precede a rise in mosquito breeding.
• Second trigger: this is activated when weekly dengue caseloads surpass 1,500 cases in May, June, July, December or January, or when district figures exceed 1.5 times the monthly average, based on Ministry of Health data.

These triggers provide a lead time of two to four weeks in which preventive actions can be initiated.

Predefined, community-based interventions

Once the simplified EAP has been activated, the Sri Lanka Red Cross Society will carry out predefined actions in the high-risk districts, including:

• the identification of high-risk zones with the districts
• community-based surveillance and the elimination of mosquito breeding sites
• clean-up campaigns and school-awareness programmes, including initiatives focused on solid-waste management and hygiene promotion
• volunteer training and hospital support
• prepositioning vector-control kits and information, education and communication materials.

Community volunteers and local Red Cross units will play a vital role in localizing the actions, for example by identifying the high-risk zones and preparing for seasonal surges in dengue cases.

A scalable model for epidemic preparedness

The Simplified EAP: Sri Lanka | Dengue is valid for a two-year period (which can be extended) and is expected to significantly reduce the country’s annual dengue burden. It also provides proof of concept for anticipatory actions ahead of epidemics. The Sri Lanka Red Cross Society aims to build on this achievement by exploring the development of a full EAP, which will expand the reach and effectiveness of the actions.