Developing a progressive control pathway for African animal trypanosomosis

Progressive control pathways (PCPs) are stepwise approaches for the reduction, elimination, and eradication of human and animal diseases. They provide systematic frameworks for planning and evaluating interventions. Here we outline a PCP for tsetse-transmitted animal trypanosomosis, the scourge of poor livestock keepers in tropical Africa. Initial PCP stages focus on the establishment of national coordination structures, engagement of stakeholders, development of technical capacities, data collection and management, and pilot field interventions. The intermediate stage aims at a sustainable and economically profitable reduction of disease burden, while higher stages target elimination. The mixed-record of success and failure in past efforts against African animal trypanosomosis (AAT) makes the development of this PCP a high priority. Trends: Whilst great strides are being made in the elimination of tsetse-transmitted human African trypanosomosis (HAT or sleeping sickness), progress in the control of African animal trypanosomosis (AAT or nagana) is patchy at best. Progressive pathways (or stepwise, staged approaches) are increasingly used for the control of a number of human and animal diseases, including foot-and-mouth disease, peste des petits ruminants, brucellosis, and rabies. A range of tools are coming of age, which enable an evidence-based prioritization, planning, and monitoring of interventions against AAT, including geographic information systems (GIS), species distribution models, and population genetics. Whilst the development of novel drugs against AAT lags behind, the array of techniques for vector control has broadened, and knowledge on their optimal field of application has improved. Among growing concerns on the capacity of sub-Saharan Africa to feed itself in the coming decades, removing the constraints posed by AAT appears more urgent than ever. (Résumé d'auteur