Most of the failures of development projects in general, and T&T control programmes in particular, have been attributed to the fact that potential and actual beneficiaries were left out of the process related to design, formulation and implementation of policy. There is now an urgent need for the new approach to become driven by demand rather than supply. The major objective of this review was to re-emphasize the need and the importance of socio-economic and cultural factors in pursuing sustainability of control programmes when external funding, on which most tsetse projects are based, comes to an end. The money spent on economic analysis would be wasted if it does not improve the ability of planners to make better decisions regarding the implementation and sustainability of trypanosomiasis control programmes. In this respect, a distinction needs to made between macroplanning, which takes a telescopic view of the entire life of the programme to derive quantitative measures of its social profitability, and microplanning, which deals with day-to-day operations and functioning of the programme as modelled by local institutions, social rules and norms. There are several lessons to be learned from the growing disillusionment with both large-scale, government-managed schemes and the questionable sustainability of most small-scale, community-based programmes, which will help to determine when and how it might be appropriate to involve communities and individual livestock owners in T&T control.