WHO Leads After Action Review to Boost Dengue Preparedness in Cox’s Bazar

On 28 May 2025, the World Health Organization (WHO), in collaboration with the Civil Surgeon’s Office of Cox’s Bazar and the Refugee Relief and Repatriation Commissioner (RRRC), convened a one-day After Action Review (AAR) workshop to evaluate the response to the 2024 dengue outbreak in the Rohingya refugee camps and surrounding host communities. The workshop brought together over 40 key stakeholders, including representatives from government agencies (RRRC and District Civil Surgeon), the health and WASH sectors, Climate and Environment actors from Cox’s Bazar District, and partners involved in the Rohingya Refugee response.

The 2024 dengue outbreak was the largest and most prolonged since 2018, with 16,556 confirmed cases and nine deaths. it placed significant strain on health facilities and community resilience, especially as it coincided with a cholera outbreak. Despite a prompt and robust multi-sectoral response led by WHO, including agile surveillance, effective case management, and coordinated RCCE, WASH, and environmental interventions, the After-Action Review (AAR) identified several key challenges. These included inadequate vector surveillance, fragmented environmental interventions (such as water and waste management by campsite management and WASH actors), and limited cross-sectoral coordination.

Epidemiological Surveillance – Trends or RDT positive cases 2018-2025.
Source: WHO Early Warning Alert and Response System (EWARS) May 2025

Against this backdrop, the AAR served as a vital platform to assess the response efforts, identify operational gaps, and strengthen preparedness for future outbreaks.

 “We must institutionalise these response protocols and ensure that frontline actors are empowered to act swiftly and collaboratively,” said Dr Abu Toha, Health Coordinator, RRRC Office. “Preparedness is not just about resources, it’s about readiness, clarity of roles, and trust among partners.”

Participants at the workshop engaged in in-depth technical discussions and scenario-based reflections to review coordination mechanisms, assess the effectiveness of risk communication and vector control measures, and propose improvements for future outbreak responses, all with an emphasis on aligning efforts with the One Health approach.

Emphasising the importance of long-term behaviour change, Sansana Deeba, WASH Associate at UNHCR Cox’s Bazar Field Office, remarked, “Sustainable health outcomes depend on continuous community education and infrastructure that supports hygienic living conditions. Behaviour change is not a one-time campaign.”

Participants collaborate in breakout sessions to critically assess the 2024 dengue outbreak response and propose actionable strategies for stronger preparedness in the future. 
Photo Credit: WHO/Terence Ngwabe Che

The workshop also addressed the strain the outbreak placed on epidemiological surveillance and public health response systems. “We were dealing with an unprecedented public health challenge,” said Dr David Otieno, WHO Team Lead for Epidemiology and Surveillance. “Our systems responded under pressure, but the gaps showed us exactly where we need to strengthen our preparedness."

Several key priorities emerged from the discussions, including strengthening community-based surveillance, investing in sanitation infrastructure, improving inter-agency coordination, and ensuring timely access to diagnostics and vector control resources. “The After-Action Review helps turn our experiences into structured learning,” said Dr Jorge Martinez, Head of Sub-Office for WHO in Cox’s Bazar. “What matters most is ensuring that every lesson translates into measurable improvements in our response to the next emergency.”

Participants share key insights and recommendations from their group discussions.
Photo Credit: WHO/Terence Ngwabe Che

The event concluded with a plenary session in which participants shared lessons learned, good practices, and concrete recommendations for revising preparedness and response strategies, including protocols for dengue prevention, detection, and management. These insights will inform future training, planning, and investment efforts aimed at enhancing epidemic readiness in one of the world’s most complex humanitarian settings. This initiative has been made possible with the support of the European Union Civil Protection and Humanitarian Aid Operations (ECHO).

For more information on this publication, please email Terence Ngwabe Che, External Communications Officer at WHO Cox’s Bazar Office, Bangladesh, at chet@who.int.