International assistance to intervention policies and implementation of area-wide tsetse and animal trypanosomiasis programmes

Full text: Tsetse-transmitted trypanosomiasis is a human and animal disease problem that directly and indirectly affects African livestock and agricultural output, rural socio-economic development, human health and welfare. The overall economic impact of African animal trypanosomiasis (AAT) is estimated at USD 4.75 billion per annum in benefits than could otherwise have been obtained in the agriculture and livestock sector. With regards to human African trypanosomiasis (HAT), an effective active surveillance programme would need to cover 70 percent of the people at risk, for which some USD 35 million per year would be needed, not including the cost of drugs needed for treating all detected cases. Efforts against the AAT problem require a prioritised approach as part of sustainable agriculture and rural development (SARD). As the spread of HAT over the past decades, was furthered by many socio-economic factors, such as political instability, wars and poverty, effective and sustainable intervention efforts against HAT require to be established as part of overall public health initiatives. A removal of the tsetse and trypanosomiasis (T and T) problem is expected to have a catalysing effect on rural development, on public health and on reducing poverty and food insecurity. A variety of agro-ecological settings (geo-climatic factors and trends, land-use patterns, livestock systems and crop agriculture practices) prevail in tsetse-infested sub-Saharan Africa and result in heterogeneous landscape scenarios in terms of HAT foci, AAT prevalence, farming, poverty and food security. Consequently, priority areas, where T and T intervention is most urgently needed and is expected to produce tangible and sustainable benefits, are to be selected not merely on the basis of the technical feasibility to alleviate or eliminate disease, but also and perhaps foremost on the need for emergency assistance - particularly regarding HAT - and the potential for sustainable public health and agricultural development. The Programme Against African Trypanosomiasis (PAAT) and the Pan African Tsetse and Trypanosomiasis Eradication Campaign (PATTEC) of the African Union jointly developed a set of criteria and guiding principles to assist tsetse-affected countries in the selection of priority areas for intervention against the AAT problem. The concept of area-wide integrated pest management (AW-IPM) has been designed to address geographically and ecologically well demarcated tsetse fly populations impacting seriously on SARD and to ensure efficiency of the intervention and sustainability of results. AW-IPM exploits favourable trends (entomological, agro-ecological, climatic, anthropogenic and epidemiological), which may assist in redressing the impact of the disease. Thus, substantial benefits from interventions are believed to result, particularly for the development of mixed-crop-livestock systems in the 'cotton-belt', a transfrontier area of Burkina Faso and Mali, and in the southern part of the Rift Valley in Ethiopia. With regards to HAT, priority countries for intervention, as far as WHO is concerned, include Angola, Chad, Congo, Cote d'Ivoire, Democratic Republic of Congo, Guinea and Sudan. For HAT the next challenge is the development of tools, supporting the strategies for the elimination of the disease. Sets of measures against the HAT and the AAT problem, as part of overall efforts directed at improved public health and SARD, respectively, will necessitate an integration of technical, institutional, socio-economic, public health and agricultural development considerations. This integrated approach will, in turn, provide the supportive environment for emergency interventions in HAT foci, balanced investments in AAT programmes, amalgamated with the AW-IPM concept, as preliminary essential steps for technical success, anticipated SARD impact and sustainability. In the context of the described overall agricultural development and public health framework the mandated international organisations provide advice and assist T and T affected Member States in project identification, fund raising and eventual implementation of AW-IPM efforts against the T and T problem. (author)