Stakeholder Narratives on Trypanosomiasis, Their Effect on Policy and the Scope for One Health.
Stakeholder Narratives on Trypanosomiasis, Their Effect on Policy and the Scope for One Health.
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DOI：
10.1371/journal.pntd.0004241
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发表时间：
2015-12
影响因子：
3.8
通讯作者：
Machila N
中科院分区：
文献类型：
--
作者：
Grant C;Anderson N;Machila N
本文探讨了锥虫病，一种广泛的和潜在的致命的人畜共患疾病传播的采采蝇（Glossina物种）影响人类和牲畜的框架。这是一个国家案例研究，重点是赞比亚知识的政治经济学。现在是审查这个问题的适当时机，因为人口增长和其他因素导致人口迁移到采采蝇居住的地区，而牲畜的历史影响很小。疾病在新的人类-野生动物界面传播的风险更大，关于管理这一点的最佳方法的意见分歧很大。定性的案例研究方法被用来检查锥虫在赞比亚的政策背景下，通过一系列的关键线人访谈的叙述。受访者包括来自国际组织、研究机构和当地活动家的主要参与者，他们从各种角度承认有必要探索人类、动物和环境部门之间的关系。主要行为者从野生动物和环境保护、农业发展、减贫以及兽医和公共卫生等不同角度出发，持有不同的框架。从这些观点出发，确定了关于锥虫病政策的四种说法，集中在四个不同的信念：锥虫病是保护环境，造成贫困，不是一个主要问题，最后，这是赞比亚而不是国际问题。在这些叙述中，也有关于最佳控制方法的相互冲突的观点，以及反应途径背后的不同推理。这些都是基于人、土地、动物、经济和环境的明显不相容的优先事项。在何种程度上一个健康的方法已被接受，这作为一种调和这些框架和叙述的目的的潜在有用性被认为是整个文件。虽然历史上一直缺乏在这种情况下工作的一个健康，影响疾病的复杂，相互作用的因素表明，需要跨部门，跨学科的决策，以阻止竞争的叙述导致竞争的行动。其他建议包括：开展监测，以评估疾病报告不足和由此造成的疾病风险估计不足的情况;循证决策;增加各国的供资并对其进行结构性管理;重点关注疾病驱动因素、社区一级的疾病发病率以及贫困和公平影响之间的相互作用。本文探讨了不同利益相关者对锥虫病的不同看法，锥虫病是一种由采采蝇传播的广泛且可能致命的疾病，影响人类和动物。这是一个重要的时间来研究这个问题，因为人口增长和其他因素导致迁移到新的地区，其中居住的采采蝇，这可能会影响疾病的水平。这意味着人类及其牲畜面临更大的风险，关于管理这种疾病的最佳方法的意见分歧很大。跨部门工作在历史上并没有使用过，但打破社会科学家、自然科学家和社区专业知识之间的障碍可能会导致更好的疾病管理。
This paper explores the framings of trypanosomiasis, a widespread and potentially fatal zoonotic disease transmitted by tsetse flies (Glossina species) affecting both humans and livestock. This is a country case study focusing on the political economy of knowledge in Zambia. It is a pertinent time to examine this issue as human population growth and other factors have led to migration into tsetse-inhabited areas with little historical influence from livestock. Disease transmission in new human-wildlife interfaces such as these is a greater risk, and opinions on the best way to manage this are deeply divided. A qualitative case study method was used to examine the narratives on trypanosomiasis in the Zambian policy context through a series of key informant interviews. Interviewees included key actors from international organisations, research organisations and local activists from a variety of perspectives acknowledging the need to explore the relationships between the human, animal and environmental sectors. Diverse framings are held by key actors looking from, variously, the perspectives of wildlife and environmental protection, agricultural development, poverty alleviation, and veterinary and public health. From these viewpoints, four narratives about trypanosomiasis policy were identified, focused around four different beliefs: that trypanosomiasis is protecting the environment, is causing poverty, is not a major problem, and finally, that it is a Zambian rather than international issue to contend with. Within these narratives there are also conflicting views on the best control methods to use and different reasoning behind the pathways of response. These are based on apparently incompatible priorities of people, land, animals, the economy and the environment. The extent to which a One Health approach has been embraced and the potential usefulness of this as a way of reconciling the aims of these framings and narratives is considered throughout the paper. While there has historically been a lack of One Health working in this context, the complex, interacting factors that impact the disease show the need for cross-sector, interdisciplinary decision making to stop rival narratives leading to competing actions. Additional recommendations include implementing: surveillance to assess under-reporting of disease and consequential under-estimation of disease risk; evidence-based decision making; increased and structurally managed funding across countries; and focus on interactions between disease drivers, disease incidence at the community level, and poverty and equity impacts. This paper explores the differing opinions of various stakeholders in relation to trypanosomiasis, a widespread and potentially fatal disease spread by tsetse flies which affects both humans and animals. It is an important time to examine this issue as human population growth and other factors have led to migration into new areas which are populated by tsetse flies, and this may affect disease levels. This means that there is a greater risk to people and their livestock, and opinions on the best way to manage the disease are deeply divided. Cross sector working hasn’t been used historically, but breaking down the barriers between social scientists, natural scientists and the expertise of the community could lead to better disease management.