Because vertical approaches, such as insecticidal house-spraying, to vector control problems have not been very successful in many instances in reducing the incidence of diseases such as malaria and Chagas, combined with the fact that there have been resurgences of some diseases, greater attention has been focused on « bottom-up »-type control strategies.

However, many attempts to actively involve the community in reducing its risks of becoming ill have met with failure.

It has usually proved difficult to motivate communities into action, but there have been some successes, although it is generally too early to know whether such successes can be sustained.