Should we be treating animal schistosomiasis in Africa? The need for a One Health economic evaluation of schistosomiasis control in people and their livestock.

A One Health economic perspective allows informed decisions to be made regarding control priorities and/or implementation strategies for infectious diseases. Schistosomiasis is a major and highly resilient disease of both humans and livestock. The zoonotic component of transmission in sub-Saharan Africa appears to be more significant than previously assumed, and may thereby affect the recently revised WHO vision to eliminate schistosomiasis as a public health problem by 2025. Moreover, animal schistosomiasis is likely to be a significant cost to affected communities due to its direct and indirect impact on livelihoods. We argue here for a comprehensive evaluation of the economic burden of livestock and zoonotic schistosomiasis in sub-Saharan Africa in order to determine if extending treatment to include animal hosts in a One Health approach is economically, as well as epidemiologically, desirable.