The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries, but remain major causes of ill-health and mortality across Africa, Asia, and Latin America. This neglect is, in part, a consequence of under-reporting, resulting in an underestimation of their global burden that downgrades their relevance to policy-makers and funding agencies. Increasing awareness about the causes of NZDs and how they can be prevented could reduce the incidence of many endemic zoonoses. Addressing NZDs by targeting the animal reservoir can deliver a double benefit, as enhanced animal health means a reduced risk of infection for humans, as well as improved livelihoods through increased animal productivity. Advocacy for NZD control is increasing, but with it comes a growing awareness that NZD control demands activities both in the short term and over a long period of time. Moreover, despite the promise of cheap, effective vaccines or other control tools, these endemic diseases will not be sustainably controlled in the near future without long-term financial commitment, particularly as disease incidence decreases and other health priorities take hold. NZD intervention costs can seem high when compared with the public health benefits alone, but these costs are easily outweighed when a full cross-sector analysis is carried out and monetary/non-monetary benefits--particularly regarding the livestock sector--are taken into account. Public-private partnerships have recently provided advocacy for human disease control, and could prove equally effective in addressing endemic zoonoses through harnessing social impact investments. Evidence of the disease burdens imposed on communities by the NZDs and demonstration of the cost-effectiveness of integrated control can strengthen the case for a One Health approach to endemic zoonotic disease control.

A parasitological survey in northern Lao PDR showed a remote ethnic minority village to be hyper-endemic for Taenia solium, a Neglected Tropical Disease (NTD) that impacts human and pig health. An intervention combining human Mass Drug Administration (MDA) with porcine vaccination and antihelmintic treatment was then implemented, targeting both T. solium and other soil-transmitted helminths. To understand the biosocial complexity of this integrated One Health intervention, we conducted a rapid ethnographic study exploring the transmission dynamics of T. solium and locally acceptable long-term control options. Informed by two years of project work in the village, this included six focus group discussions, 35 semi-structured interviews, a latrine survey, a school-based education meeting, participant observation and many unstructured interviews conducted over two weeks in October 2013. We found that risk behaviours were mediated by various social determinants including limited market access, interrelationships between alcohol, ancestral sacrifices and the consumption of raw pork, seasonal variations and poor latrine coverage. Only sixteen percent of households had latrines, attributed to the unacceptability of dry latrines, lack of water access, poor building techniques and poverty. Whilst women could explain T. solium transmission, most men and children could not, revealing that distributed posters/leaflets relied too heavily on text and ambiguous images. Compliance with MDA was high due to trust between project staff and village leaders. However understandings of pharmacology, minor side effects, human migration and children's fear of worms may lead to resistance in future programmes. Our research highlights the complexities of controlling T. solium and other soil-transmitted helminths in a remote ethnic minority village and the need to integrate biomedical and participatory approaches. Although we showcase the heuristic value of using rapid ethnography to inform intervention strategies as part of a One Health/NTD agenda, we also identify several possible paradoxes and conundrums in embedding locally-grounded biosocial analysis into NTD programmes. These need to be acknowledged and negotiated by multidisciplinary teams.