ASEAN Institute for Health Development, Mahidol University, 999 Salaya Phuttamonthon, Nakon Pathom, 73170, Thailand.
ASTRE, Université de Montpellier, CIRA, INRA, F-34398, Montpellier, France.
Infect Dis Poverty. 2019 May 27;8(1):36. doi: 10.1186/s40249-019-0539-3.
Drylands, which are among the biosphere's most naturally limiting and environmentally variable ecosystems, constitute three-quarters of the African continent. As a result, environmental sustainability and human development along with vector-borne disease (VBD) control historically have been especially challenging in Africa, particularly in the sub-Saharan and Sahelian drylands. Here, the VBD burden, food insecurity, environmental degradation, and social vulnerability are particularly severe. Changing climate can exacerbate the legion of environmental health threats in Africa, the social dimensions of which are now part of the international development agenda. Accordingly, the need to better understand the dynamics and complex coupling of populations and environments as exemplified by drylands is increasingly recognized as critical to the design of more sustainable interventions.
This scoping review examines the challenge of vector-borne disease control in drylands with a focus on Africa, and the dramatic, ongoing environmental and social changes taking place. Dryland societies persisted and even flourished in the past despite changing climates, extreme and unpredictable weather, and marginal conditions for agriculture. Yet intrusive forces largely out of the control of traditional dryland societies, along with the negative impacts of globalization, have contributed to the erosion of dryland's cultural and natural resources. This has led to the loss of resilience underlying the adaptive capacity formerly widely exhibited among dryland societies. A growing body of evidence from studies of environmental and natural resource management demonstrates how, in light of dryland system's inherent complexity, these factors and top-down interventions can impede sustainable development and vector-borne disease control. Strengthening adaptive capacity through community-based, participatory methods that build on local knowledge and are tailored to local ecological conditions, hold the best promise of reversing current trends.
A significant opportunity exists to simultaneously address the increasing threat of vector-borne diseases and climate change through methods aimed at strengthening adaptive capacity. The integrative framework and methods based on social-ecological systems and resilience theory offers a novel set of tools that allow multiple threats and sources of vulnerability to be addressed in combination. Integration of recent advances in vector borne disease ecology and wider deployment of these tools could help reverse the negative social and environmental trends currently seen in African drylands.
旱地是生物圈中自然限制最多、环境变化最大的生态系统之一，占非洲大陆的四分之三。因此，环境可持续性和人类发展以及病媒传播疾病（VBD）的控制在非洲一直是一项特别具有挑战性的工作，尤其是在撒哈拉以南和萨赫勒旱地。在这里，病媒传播疾病的负担、粮食不安全、环境恶化和社会脆弱性尤为严重。气候变化可能会加剧非洲众多的环境健康威胁，而这些威胁的社会层面现在已成为国际发展议程的一部分。因此，人们越来越认识到，需要更好地了解旱地人口与环境之间的动态和复杂关系，这对于设计更可持续的干预措施至关重要。
本范围界定审查重点关注非洲旱地病媒传播疾病控制面临的挑战，以及正在发生的巨大、持续的环境和社会变化。尽管气候不断变化、极端和不可预测的天气以及农业条件较差，旱地社会在过去仍得以生存甚至繁荣。然而，传统旱地社会无法控制的外部势力以及全球化的负面影响，导致旱地的文化和自然资源遭到侵蚀。这导致了旱地社会以前广泛表现出的适应能力丧失。越来越多的环境和自然资源管理研究证据表明，鉴于旱地系统的固有复杂性，这些因素和自上而下的干预措施会阻碍可持续发展和病媒传播疾病的控制。通过以社区为基础、参与性的方法来加强适应能力，这些方法建立在当地知识的基础上，并针对当地生态条件进行调整，这是扭转当前趋势的最佳选择。
通过旨在加强适应能力的方法，同时应对病媒传播疾病和气候变化日益严重的威胁，存在一个重大机会。基于社会生态系统和恢复力理论的综合框架和方法提供了一套新的工具，可以组合解决多种威胁和脆弱性来源。将病媒传播疾病生态学的最新进展结合起来，并更广泛地部署这些工具，可能有助于扭转目前在非洲旱地看到的负面社会和环境趋势。
