Human African trypanosomiasis

The world gears-up to eliminate sleeping sickness by 2020

18 April 2018 | Geneva −− An important meeting of national programme coordinators and stakeholders, which begins today at the headquarters of the World Health Organization (WHO), aims to further strengthen activities to achieve the elimination of human African trypanosomiasis as public health problem by 2020.

We now need to start planning for interruption of transmission beyond 2020 as we continue to stay well ahead of our set targets for 2018”, said Dr José Ramón Franco-Minguell, Medical Officer, WHO Department of Control of Neglected Tropical Diseases. “On the ground, we are reinforcing the capacity for passive detection of cases as national programmes continue to actively screen people in at risk areas, reaching between 2 and 2.5 million people annually over the past few years.”


In 2014, WHO established a global coordination network of stakeholders including national sleeping sickness control programmes, groups developing new tools, international and nongovernmental organizations involved in disease control, and donors.

Strengthened control and surveillance of the disease have contributed to steadily decreasing numbers of cases of gambiense sleeping sickness, which accounts for almost 98% of all reported cases. Some 2184 cases were reported in 2016, far fewer than the 2016 landmark of 4000 cases, and a 92% reduction from the baseline of 26 500 cases reported in 2000.

Over the past years, the number of fixed health facilities that are equipped to provide diagnosis and treatment has expanded to more than 1300 sites in countries where the disease is endemic.

The Democratic Republic of the Congo reports more than 80% of gambiense cases, with little more than 1000 new cases in 2017.

Changing epidemiological patterns of the disease and a lower number of cases pose a challenge to the way we tackle the disease on the ground” said Dr Gerardo Priotto, Medical Officer, WHO Department of Control of Neglected Tropical Diseases. “Our meeting this week will try to address these issues as well as maintain the commitment of all national programmes and stakeholders”.

Participants will also discuss the issue of access to endemic areas and the unstable security situation in countries such as the Central African Republic and in some areas of South Sudan as well as the development of fexinidazole – an oral medicine that may be used to treat the gambiense form of the disease.

The prospects of achieving the elimination of sleeping sickness as a public health problem by 2020 are within reach, although reaching zero transmission beyond 2020 poses new challenges.

The disease

Sleeping sickness is caused by infection with protozoan parasites. The parasite is transmitted to humans through the bite of the tsetse fly.

The disease was brought under control in the mid-1960s through intensive control programmes, but re-emerged due to weakened surveillance, reaching epidemic proportions in several regions by 1970.

Under WHO’s leadership, national control programmes, bilateral cooperation agencies and nongovernmental organizations have substantially reduced cases of the disease to unprecedented low numbers and raised hopes for its elimination as a public health problem by 2020.

Ashok Moloo

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