FORGING THE CHAIN

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Access to anti-parasitic medications has been
improved by: updating the essential list of anti-parasitic
medications; organizing a drug distribution system
in Latin America and rest of the world for both
nifurtimox and benznidazole; and linking the system
to the information and surveillance of patients, and
transmission routes worldwide.
HUMAN AFRICAN TRYPANOSOMIASIS
Reinforced control and surveillance activities in
endemic countries through support to Sleeping
Sickness National Control Programmes (SSNCPs) have
markedly decreased the number of cases reported to
WHO annually, from more than 37 000 in 1999 to 3762
new cases in 2014 (around 90% reduction). This is the
lowest figure achieved since reliable global records of
reported HAT cases became available.
To ensure access to the best treatment available,
WHO supplies the medicines and the treatment kits.
Most patients are treated with less toxic (arsenic-free)
medicines and less than 1% with melarsoprol, a more
toxic treatment. A pharmacovigilance system has
been implemented to monitor the efficacy and safety
of novel combination therapy, or NECT.
The WHO Atlas of HAT – an initiative to map cases
at village level and control activities – is an invaluable
tool for planning, executing and monitoring the process
of HAT elimination. Currently, the 195 098 cases
declared since 2000 are included in the database, of
which 94% are geo-referenced at village level. WHO
has started to build capacity at country level by providing
SSNCPs with equipment, software and training
on data management to facilitate ownership and use
of the Atlas at local level.
A WHO Expert Committee on HAT control and
surveillance was convened in 2013 to update knowledge
of the disease and a new technical report was
published.
The WHO HAT specimen bank supports research
in new diagnostic tools by coordinating research
institutions’ work and helping to supply the biological
material necessary to develop new prototypes or
diagnostic tests.
The HAT elimination network ensures coordinated,
strengthened and sustained efforts to battle
the disease. This functional network includes SSNCPs,
groups developing new tools to fight HAT, international
agencies, NGOs and donors.
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Two collaborating centres provide technical support
for HAT control and surveillance: the Department
of Parasitology at the ITM in Antwerp (Belgium)
and Research Unit 177 of the Institut de Recherche
pour le Développement (IRD), based in the Centre
International de Recherche-Développement sur
l’Elevage en zones Subhumides (CIRDES) in Bobo-
Dioulasso (Burkina Faso).