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Programme Against African Trypanosomosis (PAAT)

Stage 1: Laying the Groundwork

The focus of Stage 1 is to develop technical capacities and to gain a sufficient understanding of AAT distribution, risk and impact for an evidence-based planning of field activities. The latter will be implemented in Stage 2 and beyond.

Capacity development

Essential capacities include project management, veterinary and entomological competencies in parasitological and serological surveillance, trapping and identification of vector species, and AAT and vector control. Skills in data management and geographic information systems (GIS) to enable mapping, risk assessment and monitoring are also needed [1, 2].

Essential capacities must be built within the SNS, but more advanced ones (e.g. molecular diagnosis [3], geospatial modelling [4]), can be available from national or regional centres and laboratories, as well as from international institutions.

Understanding AAT risk and impact

The establishment of a national-level information system is another pillar of Stage 1. All recent epidemiological and entomological data should be assembled, harmonized, geo-referenced and centralized. National atlases can be developed [1], also using methodologies from the FAO continental Atlas of tsetse and AAT [5, 6]. Targeted field investigations should be conducted where gaps exist or where available information is too old to inform decision making. More generally, all necessary data for an evidence-based, rational selection of intervention areas and strategies need to be collected in Stage 1. In particular, if a fast-tracking to the elimination pathway is envisaged (Stage 3 and beyond), genetics studies are likely to be needed to establish the degree of isolation of the target tsetse populations [7, 8] and the related risk of reinvasion.

Socio-economic information on the burden of AAT is essential to justify investment and to prioritize areas for intervention. Spatially-explicit benefit-cost analyses [9, 10, 11], tsetse and AAT distribution maps [1, 5, 6] and models of tsetse distribution and isolation [4, 12] are tools that should support a rational selection of intervention areas and strategies. The occurrence and risk of HAT [13-15] should be considered, as interventions promoting One Health bring broader benefits and are more likely to attract resources [16, 18]. Security constraints (i.e. civil strife, armed conflicts, etc.) should not be overlooked.                

Pilot field interventions

While substantive field interventions are the focus of subsequent stages, pilot field activities against tsetse and AAT should be carried out in Stage 1. Their aim is to develop national capacities, fine-tune and optimize intervention tools, and motivate donors. Furthermore, throughout the PCP, field interventions may be needed to tackle possible AAT epidemics [19], including in Stage 1.

Steering committee

Stage 1 should also look at coordination. A steering committee should be set up, for orientation and supervision of the SNS and its activities. Membership should include national stakeholders (i.e., all concerned ministries such as livestock, agriculture, health, environment, etc.), as well as regional and international actors (e.g., regional economic communities (RECs), international organizations, and research institutions).

Selection of priority intervention areas and interventions strategies

Stage 1 culminates in the choice of priority intervention areas [20] and most appropriate strategies for the selected areas (AAT sustainable reduction or elimination). Importantly, the most likely strategy for subsequent stages can, to some extent, influence activities in Stage 1. For example, requirements in terms of data and capacities differ between the sustainable reduction and elimination scenarios, and this could affect activities and duration of Stage 1.T


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