Deadly Flies, Poor Profits, and Veterinary Pharmaceuticals: Sustaining the Control of Sleeping Sickness in Uganda

ABSTRACT

Efforts to control neglected tropical diseases have increasingly focused on questions of implementation. But how should we conceptualize the implementation process? Drawing on ethnographic fieldwork between 2010 and 2012, in this article I explore efforts by a small-scale public–private partnership to use private veterinarians to sustainably control zoonotic sleeping sickness in Uganda. With a fundamental tension between business incentives and vector control, I show how divergences in knowledge, power, values, and social norms shaped project implementation and community responses. Reflecting more widely on the relationships between project plans and local realities, I argue that these encounters reveal the heuristic value in approaching global health interventions as evolving ‘social experiments.’ This metaphor reveals the uncertainty inherent to dominant narratives and models, the role of available expertise in defining the limits of action, and the need for continuous adaption to synchronize with emergent social and institutional topographies.

KEYWORDS:

• Implementation
• NTDs
• sleeping sickness
• Uganda
• veterinary drugs

Acknowledgments

I would like to thank Prof. Sue Welburn of the University of Edinburgh for her unwavering support during the last five years; Prof. Charles Waiswa for guidance in Uganda; Prof. James Smith and Dr. Lawrence Dritsas at University of Edinburgh, who provided supervisory support during my doctoral thesis; and a number of SOS partners and affiliates for their critical comments on previous manuscript drafts, including helpful clarifications from Anne Rannaleet of IKARE. I would also like to thank the many people in Uganda who supported, assisted, and participated in this research project—there are just too many to name here! Special acknowledgements go to the many individuals and families I interviewed north of Lake Kyoga who have, and continue to, suffer from the devastating effects of HAT. Let your load be a light one.

Funding

This research was supported by SOS partners based at the University of Edinburgh through DFID’s Research Into Use Program, as well as the European Union’s Seventh Framework program (FP7/2007–2013) under grant agreement 221948 Integrated Control of Neglected Zoonoses (ICONZ): (http://www.iconzafrica.org).

Notes

1. Research methods have been described previously in Bardosh and colleagues (2013). Fieldwork was done with the assistance of five different local researchers not associated with SOS (acting as translators and enumerators for my surveys) to accommodate the three linguistic groups in the area: Lango, Kumam, and Ateso. Ethical clearance was obtained from The University of Edinburgh.

Additional information

Funding

This research was supported by SOS partners based at the University of Edinburgh through DFID’s Research Into Use Program, as well as the European Union’s Seventh Framework program (FP7/2007–2013) under grant agreement 221948 Integrated Control of Neglected Zoonoses (ICONZ): (http://www.iconzafrica.org).

Notes on contributors

Kevin Louis Bardosh

Kevin Bardosh (PhD, African Studies) is currently a research fellow at the University of Edinburgh and University of Florida. He has conducted anthropological research on a number of neglected tropical diseases in Africa and Asia, and is editor of the book, One Health: Science, Politics and Zoonotic Disease in Africa (2016).