Neglected tropical diseases

Lowest caseload recorded as the world prepares to defeat sleeping sickness

16 April 2016 | Geneva −− Human African trypanosomiasis or HAT (also known as sleeping sickness) could be eliminated as a public health problem by 2020 if progress is sustained. Gambiense HAT, the commonest form of the infection in humans, has reached its lowest level since the disease was targeted for elimination as a public health problem in WHO’s 2012 roadmap on neglected tropical diseases.

The second meeting of gambiense HAT stakeholders (Geneva, 21–23 March 2016) noted that fewer than 3000 new cases were recorded in 2015, the lowest level since the start of systematic global data collection 75 years ago.

“We met to review the epidemiological situation and technical aspects of the disease for moving towards elimination” said Dr José Ramón Franco Minguell, WHO Medical Officer for HAT. “The main challenges include the development of novel medicines and ensuring access to screening and diagnostic tools, as well as improved methods of vector control and epidemiological tools to enhance surveillance of the disease.”

The meeting also discussed research on unresolved epidemiological aspects such as the role of asymptomatic carriers and animal reservoirs, and examined the mechanisms for assessing the elimination process as well as the attempts to estimate unknown factors through modelling.

The meeting noted the significant progress that has been made since the first stakeholders’ meeting (Geneva, 2014). The WHO-led network commended the important advances made by country programmes and emphasized the importance of coordinated activities as the epidemiological situation changes and further gains towards eliminating gambiense HAT as a public health problem are made.

The meeting made a number of recommendations, some of which include the need for:

  • resources to support staff training and sustain their motivation;
  • improved screening and diagnostic tools as well as sufficient coverage and enhanced cross-border collaboration;
  • integrated activities for control and surveillance into strengthened national health systems; and
  • sustained and strengthened data collection, management and mapping, all of which are critical for decision making.

The meeting was attended by a wide range of stakeholders, including representatives from national sleeping sickness programmes of the health ministries of 17 countries affected by gambiense HAT,1 international organizations involved in HAT1 control,2 nongovernmental organizations,3 non-profit organizations4 and research institutes5 developing new tools against HAT, academia6 and major international donors,7 including private sector companies such as Sanofi, Bayer HealthCare and General Electrics Healthcare, bilateral agencies such as the Belgian Development Cooperation, and philanthropic organizations such as the Bill & Melinda Gates Foundation.

1Angola, Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Ghana, Guinea, Mali, Nigeria, South Sudan, Togo, Uganda.
2Food and Agriculture Organization of the United Nations (FAO), International Atomic Energy Agency (IAEA), African Union Commission (AU)/Pan African Tsetse and Trypanosomiasis Eradication Campaign (PATTEC).
3Médecins Sans Frontières (MSF).
4Drugs for Neglected Diseases initiative (DNDi), Foundation for Innovative New Diagnostics (FIND).
5Institute of Tropical Medicine (ITM – Belgium), Institute for Disease Modeling (IDM – USA), Institut National de Recherche Biomédicale (INRB – DRC), Liverpool School of Tropical Medicine (UK), Swiss Tropical and Public Health Institute (STPH – Switzerland), Instituto de Higiene e Medicina Tropical (IHMT – Portugal), Institut de Recherche pour le Développement (IRD – France), African Insect Science for Food and Health (ICIPE – Kenya).
6Makerere University (Uganda), University of Glasgow (UK), Oregon State University (USA), Yale University (USA), University of Oxford (UK, absent with apologies), University of Warwick (UK).
7Bayer, Bill & Melinda Gates Foundation, General Electrics, Sanofi.

Ashok Moloo

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