Research: the prerequisite for innovative strategies and technologies

The search for new strategies and technologies for the control of yaws, a genuine but much neglected tropical disease problem, has been largely unsuccessful. This disease, with conspicuous early symptoms and a late crippling pathology, attracted the attention of the first generation of tropical doctors. As soon as specific therapy became available in the early part of the 20th century, mass treatment campaigns were started. The availability and efficacy of penicillin led some to anticipate yaws eradication; this expectation was not met but rather induced a false sense of security. After varying intervals resurgences occurred in several endemic regions. It is important to analyze this failure so that mistakes and underestimated or overlooked factors can be identified. On the whole, the main difficulty has been a lack of interest in a presumably disappearing disease and a consequent failure to take advantage of the benefits offered by recent advances in basic biomedical technology. Solid clinical, epidemiologic, and sociocultural data in connection with mass treatment and control are still needed. Research of high quality, with continuous assessment in the field, is a prerequisite for innovative strategies and technologies.