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What sleeping sickness in Uganda can teach us about fighting Ebola
The current outbreak of Ebola in West Africa (and perhaps elsewhere) and now Marburg Fever, a related a hemorrhagic fever virus in Uganda, has generated much talk about the collective “failures” to pre-empt and control disease.
Alongside a slow international response, the blame has been placed on weak and ineffective health systems in sub-Saharan Africa. While largely true, this is of little help in thinking through what to do next? Effective systems that can ensure healthcare provision and disease surveillance would be ideal but remain a longer-term project in many parts of the world.
A further complication is that these zoonotic diseases where infections take places between humans and animals often have complex transmission patterns that are not always fully understood. What examples might guide future responses to complex, zoonotic and potentially global infections? A “One Health” approach – in which human health, animal health and environmental factors are monitored and addressed in an integrated manner has emerged as a policy aspiration – particularly following the Avian influenza outbreaks since 2003. What does it take, however, to make such co-ordination and planning a reality?
Important examples of success exist. Efforts to control and eliminate African Trypanosomiasis (known as “sleeping sickness”) in Uganda make an instructive case in tackling a highly complex disease. Sleeping sickness control is difficult because of the sheer intricacy of the disease: the vector (the tsetse fly) is difficult to control, what drugs are available to treat the disease are toxic and are thus dependent on a positive diagnosis, which in itself presents major technical problems.