Paper short abstract:

Local methods of control are essential for tackling NTDs. The example of African trypanosomiasis demonstrates that a range of often low-tech techniques offer effective and cheap means of disease control. Supporting and expanding these activities should be an important facet of NTD policy.

Paper long abstract:

This paper argues that an increased emphasis on local methods of control for neglected tropic diseases (NTDs) is essential towards meeting the goals of the London Declaration.

Much activity in tackling NTDs in the last decade has focused on developing new treatments, vaccines, and, to a lesser extent, diagnostics. As importance as these interventions are, there is a risk overstating both their feasibility, and the ease of which they can be implemented. In contrast, control measures may offer much cheaper and more cost effective solutions.

Using the case study of African trypanosomiasis, a survey of academic and non-academic literature demonstrates that a wide variety of techniques are used to minimise disease exposure. Practices as diverse as clearing vegetation, trapping insects, controlling cattle movements, and different forms of insecticide spraying are just some of the valuable tools used to mitigate African trypanosomiasis.

However, such techniques are often sidelined in various ways: they are seldom given sustained attention by researchers, making it difficult to precisely gauge their effectiveness. They have in many (but not all) cases detached from coordinated control programmes, instead becoming more diffuse, privately organised activities, with mixed consequences. And the ways in which local knowledges and innovations could be supplemented and expanded by international resources has been conspicuously neglected by the NTD policy community.

In conclusion, the example of African trypanosomiasis demonstrates that, with certain limitations, local methods of control and mitigation offer a significant pathway towards tackling NTDs: potential that should be explored further in future research.