Parasitology

The journey towards elimination of gambiense human African trypanosomiasis: not far, nor easy

J. R. FRANCOa1 c1, P. P. SIMARROa1, A. DIARRAa2, J. A. RUIZ-POSTIGOa3 and J. G. JANNINa1

a1 World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, 20, Av. Appia, 1211 Geneva, Switzerland

a2 World Health Organization, WHO Inter Country Support Team for Central Africa, Regional Office for Africa, IST/CA, BP 820, Libreville, Gabon

a3 World Health Organization, Communicable Disease Control, Control of Tropical Diseases and Zoonoses, Regional Office for the Eastern Mediterranean, P.O. Box: 7608, Nasr City, Cairo 11371, Egypt

SUMMARY

Considering the epidemic situation of gambiense human African trypanosomiasis (HAT) at the end of the twentieth century, the World Health Organization (WHO) and partners strengthened disease control and surveillance. Over the last 15 years, the activities implemented through the National Control Programmes have brought gambiense HAT under control and now its elimination is deemed as an achievable goal. In 2012, WHO targeted gambiense HAT for elimination as a public health problem by 2020. The final goal will be the sustainable disease elimination by 2030, defined as the interruption of the transmission of gambiense HAT. The elimination is considered feasible, because of the epidemiological vulnerability of the disease, the current state of control, the availability of strategies and tools and international commitment and political will. Integration of activities in the health system is needed to ensure the sustainability of the elimination. The development of user-friendly diagnostic and treatment tools will facilitate the integration process. Adequate funding is needed to implement activities, but also to support research that will make the elimination sustainable. A long-term commitment by donors is needed and ownership of the process by endemic countries is critical.

(Received October 04 2013)

(Revised November 19 2013)

(Revised November 20 2013)

(Accepted November 21 2013)

(Online publication January 28 2014)

Key words

  • Human African trypanosomiasis;
  • HAT;
  • sleeping sickness;
  • disease elimination;
  • gambiense HAT;
  • T.b. gambiense

Correspondence

c1 Corresponding author: World Health Organization, Control of Neglected Tropical Diseases, Innovative and Intensified Disease Management, 20, Av. Appia, 1211 Geneva, Switzerland. E-mail: francoj@who.int

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