Abstract
BackgroundDuring the last century, WHO led public health interventions that resulted in spectacular achievements such as the worldwide eradication of smallpox and the elimination of malaria from the Western world. However, besides major successes achieved worldwide in infectious diseases control, most elimination/control programs remain frustrating in many tropical countries where specific biological and socio-economical features prevented implementation of disease control over broad spatial and temporal scales. Emblematic examples include malaria, yellow fever, measles and HIV. There is consequently an urgent need to develop affordable and sustainable disease control strategies that can target the core of infectious diseases transmission in highly endemic areas.DiscussionMeanwhile, although most pathogens appear so difficult to eradicate, it is surprising to realize that human activities are major drivers of the current high rate of extinction among upper organisms through alteration of their ecology and evolution, i.e., their “niche”. During the last decades, the accumulation of ecological and evolutionary studies focused on infectious diseases has shown that the niche of a pathogen holds more dimensions than just the immune system targeted by vaccination and treatment. Indeed, it is situated at various intra- and inter- host levels involved on very different spatial and temporal scales. After developing a precise definition of the niche of a pathogen, we detail how major advances in the field of ecology and evolutionary biology of infectious diseases can enlighten the planning and implementation of infectious diseases control in tropical countries with challenging economic constraints.SummaryWe develop how the approach could translate into applied cases, explore its expected benefits and constraints, and we conclude on the necessity of such approach for pathogen control in low-income countries.
Highlights
During the last century, WHO led public health interventions that resulted in spectacular achievements such as the worldwide eradication of smallpox and the elimination of malaria from the Western world
Emblematic examples include malaria in Africa [9] where both the parasite and its mosquito vector species have developed high levels of resistance to the most widely used drugs and insecticides, further jeopardizing control as well as elimination efforts [10,11]. Yellow fever is another frustrating example where the pathogen remains endemic in many countries [12] despite the availability of an deliverable and affordable vaccine [13] and because of uncontrolled sylvatic transmission cycles [14] allowing virus maintenance In turn, the current eradication campaign against poliomyelitis illustrates a tradeoff between limited available economic resources and their allocation to solve the myriad of problems that conflict or post-conflict countries have to confront without functioning governance and public administrations [15]
Whereas most pathogens appear so difficult to control, to eliminate and/or to eradicate, evidence is accumulating that human-induced environmental changes and habitat destruction impact the ecology and evolution of upper organisms and contribute significantly to the current high rate of extinction [25]
Summary
Whereas most pathogens appear so difficult to control, to eliminate and/or to eradicate, evidence is accumulating that human-induced environmental changes and habitat destruction impact the ecology and evolution of upper organisms and contribute significantly to the current high rate of extinction [25]. Creating synergy from improvements produced by the pathogen niche approach While the benefits of using evolutionary theory to improve current diseases control tools can be seen as intuitive and are well-known to the public health community workers, the major breakthrough due to the pathogen niche approach is synergy stemming from the combination of such improvements, and the ability to capitalize on them For this to occur, careful tailoring of implementations in space and time will be required. We believe that mathematical modeling, extensively used into the study of ecology and evolution of infectious diseases to connect theoretical mechanisms and observed patterns, is a privileged tool to design innovative strategies finely tuned to different pathogens If such low-cost solutions, direly needed in economically constrained countries, can be identified and proved successful from both a theoretical and applied standpoint, it could be extended to other parts of the World and applied at a global scale
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
