by David Hendrickx
The NTD (neglected tropical diseases) debate continued this morning at the ITM-IPH colloquium with a closer look at a few key challenges the research community is being faced with in terms of informing NTD control initiatives. Although the session focused predominantly on the case of visceral leishmaniasis and its control in the Indian subcontinent, the questions discussed throughout the presentations and discussions were just as relevant to other NTDs. What is the precise role of vector control in reducing disease incidence? What is the best vector control strategy, considering factors such as (cost-)effectiveness, acceptability and risk of insecticide resistance? What is the role of asymptomatic carriers of infection in disease transmission? How can we effectively and safely treat patients for these conditions, without running the risk of losing the few drugs we currently have at our disposal to drug resistance?
These were just a few of the questions that were raised. It was sobering (yet fitting, for a neglected problem?) to observe that many of the presented studies put forward more questions and ‘known unknowns’ than they provided answers and clear ways forward. It feels like we are slowly piecing together a huge and complex puzzle, with the added challenge of not knowing how many pieces we will need, nor what the picture on the box looks like. So where should our research priorities lie in terms of NTD control? And should we focus on implementing what we think we know? Or would we be wise to invest more time and resources in exploring alternate control strategies and possible ‘unknown unknowns’? As we continue to piece together the puzzle of NTD control, it remains clear that our continued research efforts are much needed, whatever our discipline or expertise.