ABSTRACT
During the past two decades, vector-borne diseases such as yellow fever, dengue fever, and malaria have become increasingly prevalent and more widespread [ 1 ,21 . These re-emerging or resurging diseases now cali se even more murbidity and morta lity than occurred during the early 1 900s , when successful prevention and control programs were initiated . As many as 1 00 million people each year are afflicted with dengue fever, with approximately 500 ,000 experiencing the severe form of disease, dengue hemorrhagic fever, which has an average 5 % case fatality rate [3 ] . An estimated 200,000 people are infected annually with yellow fever, with up to 2 0 to 3 0,000 deaths, but this is believed to be an underestimate due to inadequate surveillance [4 1 . Estimates for malaria range as high as 200 to 300 mi llion cases alld 1 . 1 million deaths per year [5J . As staggering as these figures are, it is the rate at which the incidence of these diseases has increased in last two decades that is of concern. This is particularly problematic because these diseases were successfully controlled in the 1 950s and 1 960s [ 1 ,2 ] .
What has led to this dramatic resurgence of disease ? This reviews the experience of yellow fever, dengue, and malaria, with attention to that can be gleaned to help direct p ublic health policy and intervention aimed at reversing this alarming trend, lessons learned from the past, and what kind of renewed action is required to reduce the present burden of these diseases and l essen the chances that climate-related risks will exacerbate the current situation.
