Addressing vulnerability, building resilience: community-based adaptation to vector-borne diseases in the context of global change

Abstract

BackgroundThe threat of a rapidly changing planet – of coupled social, environmental and climatic change – pose new conceptual and practical challenges in responding to vector-borne diseases. These include non-linear and uncertain spatial-temporal change dynamics associated with climate, animals, land, water, food, settlement, conflict, ecology and human socio-cultural, economic and political-institutional systems. To date, research efforts have been dominated by disease modeling, which has provided limited practical advice to policymakers and practitioners in developing policies and programmes on the ground.Main bodyIn this paper, we provide an alternative biosocial perspective grounded in social science insights, drawing upon concepts of vulnerability, resilience, participation and community-based adaptation. Our analysis was informed by a realist review (provided in the Additional file 2) focused on seven major climate-sensitive vector-borne diseases: malaria, schistosomiasis, dengue, leishmaniasis, sleeping sickness, chagas disease, and rift valley fever. Here, we situate our analysis of existing community-based interventions within the context of global change processes and the wider social science literature. We identify and discuss best practices and conceptual principles that should guide future community-based efforts to mitigate human vulnerability to vector-borne diseases. We argue that more focused attention and investments are needed in meaningful public participation, appropriate technologies, the strengthening of health systems, sustainable development, wider institutional changes and attention to the social determinants of health, including the drivers of co-infection.ConclusionIn order to respond effectively to uncertain future scenarios for vector-borne disease in a changing world, more attention needs to be given to building resilient and equitable systems in the present.Electronic supplementary materialThe online version of this article (doi: 10.1186/s40249-017-0375-2) contains supplementary material, which is available to authorized users.

Emerging arbovirosis (Dengue, Chikungunya, Zika) in the Southeastern Mexico: influence of social and environmental determinants on knowledge and practices. A mixed method study

“…Similar findings have been previously described in other localities with recent history of the disease [28, 29, 35, 39, 40]. These outcomes suggest that knowledge does not necessarily lead to adequate prevention practices, especially in those contexts where the complex interactions of environmental and social determinants increased human vulnerability to vector borne diseases [11, 12].…”

“…Even if the SIT could represent an effective and sustainable alternative to traditional vector control programs, its introduction should be accompanied by an integrated approach including participation of local stakeholders. It has been remarked the importance of taking a community-based approach in vector borne disease interventions, especially when they include the implementation of new technologies for health [11, 18-21].…”

Tsetse Invasion as an Emerging Threat to Socioecological Resilience of Pastoral Communities in Karamoja, Uganda

“…Thus, they affect the resilience of such systems by interfering with their adaptive cycle [17]. For example, in parts of northern Uganda, the spread of sleeping sickness associated with tsetse is linked to restocking efforts after decades of military conflict [82,83]. Due to the agistments associated with pastoral communities, including Karamoja, they may be gifting their kinsmen with already infected livestock.…”

Preparedness for Chagas disease spreading worldwide

“…Community-based interventions, including insecticide treated bed nets, insecticide spraying, preventive chemotherapy, and treatment, will be more effective when combining with vertical vector control programmes. This also requires high level governmental commitment along with strong partnerships among major stakeholders [11][12][13]. In wider context, the equitable system on social determinants of health and public health policies shall be built to ensure better health and living conditions for all individuals [6].…”

“…Current treatment methods and vector control measures are highly challenged by drug and insecticide resistance, which affects virtually all interventions currently used. More attention and investments are needed to improve appropriate strategy and technology [13]. Updated strategies in understanding epidemiological patterns and therapeutic outcome of the disease, as well as innovative research on development of more sensitive diagnostic tools and more efficient drugs, are also encouraged to sustain and scale up control successes in all endemic regions [10,16].…”