A strong case has recently been made by academics and policy makers to develop national control programmes for the integrated control of Africa's "neglected diseases". Uganda was the first country to develop a programme for the integrated control of two of these diseases: schistosomiasis and soil-transmitted helminths. This paper discusses social responses to the programme in northwest Uganda. It shows that adults are increasingly rejecting free treatment. Resistance is attributed to a subjective fear of side effects; divergence between biomedical and local understandings of bilharzia; as well as insufficient and inadequate health education. In addition, the current procedures for distributing drugs at a district level re-enforce resented social hierarchies. It is suggested that the programme will not fulfil its stated objectives of developing a local demand for treatment unless an endeavour is made to counter the view that this particular top down, biomedical intervention is just another attempt to re-enforce political control and economic marginalisation.