Heartwater (HW) is the name given to the acute, febrile disease of ruminants caused by infection with the obligate intra-cellular rickettsia Cowdria ruminantium. The effect of losses associated with HW and dermatophilosis are an important constraint to the sustainable use of non-indigenous breeds, but recent advances in heartwater and dermatophilosis research provide optimism that integrated control of these conditions can be achieved in west Africa. The relevant advances in HW research are in methods for monitoring the status of animals at risk of developing heartwater, which allow the veterinarian and owner to identify control strategies for herds and individual animals, and developments in the field of vaccination. This paper seeks to provide information that may assist the veterinary services in west Africa in assessing and identifying opportunities for HW control. Recommendations for the activities of key institutions place an emphasis upon the isolation and identification of west African strains of Cowdria for inclusion in inactivated or live vaccines, and the need for donor support to enable field trials of integrated control methods for HW and dermatophilosis.