Learn from mistakes to get treatment right

“Unwanted side-effects” (30 May) is a thoughtful and balanced account of the issues arising from our research on mass drug administration programmes for neglected tropical diseases, but there is one point that we would like to clarify.

The feature refers to weeks of fieldwork in 2007 and 2011. In fact, we lived and researched at our sites in Tanzania for a combined total of 11 months, and have spent even longer researching local responses to drug distributions in Uganda since 2005. Several UK-based and African postgraduates have also been working with us and have similarly resided among targeted populations for prolonged periods, closely observing what has been happening. In addition, our analysis builds on our ethnographic research in the region over the past 30 years.

As the article notes, we have shown that the current MDA programmes have had mixed results. Given the scale of the operations and their top-down approach, that is not really unexpected. However, what has been surprising are some of the responses to our making the findings public. In this context it is heartening that Christopher Whitty, chief scientific adviser at the Department for International Development, has drawn attention to the dangers of exaggerating results about neglected tropical disease control and has emphasised the need for more balanced and accurate assessments of international aid.

The department’s current commitment to gathering more robust evidence and, where necessary, adjusting policy in response to it is surely a sensible way forward. We hope our work on neglected tropical diseases contributes to such a process. There is no doubt that dealing with these terrible diseases in an effective way can transform the lives of impoverished people. That requires learning from what works and what does not, and being honest and open about problems as they arise.

Melissa Parker
Brunel University

Tim Allen
London School of Economics