At the tipping point for eliminating the African sleeping sickness in the DRC

by Justin Mbaruku and Trad Hatton | Government of the Democratic Republic of the Congo
Monday, 10 April 2017 20:33 GMT

A general view shows Mongbwalu, a gold mining town in northeastern Democratic Republic of Congo, November 15, 2016. REUTERS/Aaron Ross

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If you haven't heard of the African sleeping sickness, you are not alone

Five years ago in London, an extraordinary group of global and country leaders, pharmaceutical chief executives, and heads of global health organizations came together to pledge to control, eliminate, or eradicate 17 neglected tropical diseases (NTDs) -- some of the world’s most deadly and overlooked illnesses -- by 2020.

Earlier this year, in Kinshasa, in the Democratic Republic of Congo (DRC), leaders from government, civil society, and donors convened to mark our progress toward that commitment and reinforce our collective dedication to eliminating one NTD that is of serious concern for our country: African sleeping sickness. Thanks to strong commitments across a range of partners, we are ambitious about our ability to finally rid our country of this devastating disease.


If you haven’t heard of African sleeping sickness -- or Human African trypanosomiasis (also called “HAT”) -- you are not alone. While it is nonexistent in Western countries, African sleeping sickness still threatens millions of people in 36 countries, mostly in sub-Saharan Africa. It remains one of the most neglected diseases in the world today, and also one of the most fatal.

The illness is transmitted by the large, biting tsetse fly, which is common to mid-continental Africa. Symptoms begin with a low-grade fever, joint pain, and itchy skin. Later, parasites enter the victim’s brain, causing hallucinations and unpredictable behavior. If undiagnosed and untreated, the victim eventually lapses into a coma and dies. The disease can spread quickly, from village to village. The earlier it is diagnosed, the more effectively it can be treated.

If untreated, African sleeping sickness is nearly 100 percent fatal.

The disease has devastating costs, and today the DRC bears the largest burden, with about 85 percent of the world’s cases. Fortunately, sustained control efforts over the last decade -- including diagnosis and treatment -- have reduced the number of cases to their lowest in years. In 2009, the number dropped below 10,000 for the first time in 50 years, and in 2015, 2,353 cases were recorded.


Today, this low number of cases -- combined with vector control, diagnostics, mapping techniques, and potential new treatments currently in development -- means that we have good reason to be optimistic. Our goal is to eliminate African sleeping sickness in the DRC by 2020, and we believe we can reach that milestone with innovation, political will, and the sustained support of our organizations -- the Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA) and PATH -- alongside other committed partners including the World Health Organization, FIND, the Drugs for Neglected Diseases Initiative, the Bill & Melinda Gates Foundation, and the Belgian Institute of Tropical Medicine.

Currently, PNLTHA -- the national program for the control of HAT under the leadership of the Ministry of Health -- executes our country’s fight against NTDs and has begun to take major strides toward elimination. We will begin by launching a five-year HAT National Strategic Plan, which demonstrates government commitment and will help to guide and coordinate our work and the work of partners. The strategy will ensure that interventions are funded and prioritized at the national and local level, and that diagnostics, control methods, and new drugs -- when and if they become available -- are incorporated into governing policy documents so they can be rolled out to at-risk areas.

In addition to policies and prioritization, awareness and prevention are critical. That is why the government is working to spur awareness and behavior change within affected communities. A widespread communication effort designed to help citizens understand how they can prevent the disease will sustain the DRC HAT Strategic Plan and reach thousands starting this year.

New technologies will also be our allies. In partnership with the University of California, Los Angeles, we hope to begin utilizing high-resolution satellite imagery and GPS to identify vulnerable populations, which will help us know where to roll out mass screening and treatment to interrupt transmission. Other new tools are also emerging. For example, it can be hard to identify the HAT parasite, especially in rural areas where technology is limited. Soon, a lab worker in the field will be able to connect their cell phone directly to a microscope and take a video, which will help to ensure quality in the identification process.


To underscore the DRC’s commitment to elimination, the Ministry of Health has advocated to Parliament to declare a national day of HAT in the country, at least until the disease is eradicated. Speaking at a recent commemoration event in Kinshasa, the Secretary General of Health emphasized that the DRC is committed to not only addressing, but eliminating African sleeping sickness.

Working together, the government, nongovernmental organizations, donors, and communities can ensure that African sleeping sickness is no longer ignored -- and that future generations are not plagued by this deadly disease.

Dr. Justin Mbaruku is deputy director of the Programme National de Lutte contre la Trypanosomiase Humaine Africaine (PNLTHA), Democratic Republic of the Congo (DRC).

Trad Hatton is country director for the Democratic Republic of the Congo at PATH, an international health NGO focused on global health innovation.