Sleeping Sickness: towards elimination?

Abstract

Sleeping Sickness (SS) is being controlled in most African countries after the epidemic that started in the 1990’s. WHO had a major role in building awareness and implementing solutions that covered capacity building, diagnosis optimization, drug availability and distribution and vector control measures. Although much remains to be done specially in countries with civil instability, the Atlas of Human African Trypanosomiasis, a WHO project now available as a tool for SS surveillance in Africa, should help reach elimination of the Gambiense form of this disease in the next 5 to 10 years. Learning from colonial SS control programs successfully established in the middle of the last century is important in the present situation; evaluating the social and anthropological components of the disease is critical for securing long term eradication. The example of Angola, where formerly epidemic SS has reached eradication stage should be studied and attentively followed up. Although SS treatment still relies on old and toxic drugs, a better combination therapy (NECT) for the neurologic stage of Gambiense disease is now available. A new oral drug able to treat both stages of the disease should be ready to be rolled- out in the coming years.