Lords of the fly: tracing tsetse control networks and the social proximity of sleeping sickness interventions in Uganda
Shona Jane Lee (London School of Hygiene and Tropical Medicine)
Paper short abstract:
Novel tsetse fly control tools play a key role in the 'one health' approach to eliminating sleeping sickness. Tracing their implementation across Uganda, I reveal fractured collaborations underpinning local tsetse control networks, and the importance of social proximity in sustaining interventions
Paper long abstract:
A decline of the vector borne disease Human African Trypanosomiasis (HAT), or 'sleeping sickness', in recent years has paved a roadmap for its elimination as a public health problem by 2020. Galvanised by this agenda, and driven by technology-oriented Public Private Partnerships, focus has shifted from reactive outbreak response to sustaining vigilant diagnostic surveillance and tsetse fly suppression 'to the last mile'. While cost-effectiveness is positioned centrally to sustainability, less emphasis is placed on the socio-technical relationships that shape the long-term legacy of interventions. How are commitments to community engagement and in-country collaboration from global health research and policy discourse enacted through local networks at community level? I present findings from ethnographic research in Uganda on the implementation of 'emerging technologies' in tsetse control, tracing the collaborative networks of researchers, entomologists, veterinarians, and health workers in their endeavour to integrate vertical programmes into fragile local human-tsetse assemblages. This reveals fissures in the 'one health' framework at ground level, where decentralised and under-resourced district offices struggle to maintain operational cohesion in precarious socio-technical ecosystems, while authoritative claims on expertise and power still firmly reside in hands of donors and research institutions in the global north. Structural gaps in infrastructure and epistemological inequity cannot be circumnavigated with technologies alone. Relatively modest, socially embedded technologies have endured where comparatively aloof, vertical mass spraying campaigns have come and gone at great expense with no long-term impact. Sustainability is shaped by the social proximity of interventions, promoting longevity through community buy-in and ownership.
Global health collaborations and alignments