Efforts to eliminate human African trypanosomiasis (HAT), also known as sleeping sickness, are continuing to show excellent progress, in line with the targets set out in WHO's 2030 road map for the control, elimination and eradication of neglected tropical diseases.
Human African trypanosomiasis has two principal forms, referred to as gambiense and rhodesiense, and is generally transmitted through contact with infected tsetse flies.
Equatorial Guinea has now been validated by WHO as being the latest country to eliminate the gambiense form of the disease as a public health problem within its borders.
The general incidence of the gambiense form of the disease has reduced sharply this century. In 2021, 750 cases were reported in 11 endemic countries – this represented a 95% reduction in the number of cases when compared to the figure for 2001 (26 095 cases). Other countries have also seen their elimination of the disease as a public health problem validated by WHO recently – Equatorial Guinea now joins Benin, Côte d'Ivoire, Togo and Uganda on that growing list.
Longstanding work and commitment by the Ministry of Health of Equatorial Guinea, through its human African trypanosomiasis National Control Program (PNCTHA), has allowed the country to reach the threshold established for validating elimination. This threshold is defined as fewer than 1 case per 10 000 inhabitants on average, over the last five years, in all of the country's health districts. Validation of elimination requires countries to submit extensive dossiers to WHO. These are then assessed by an independent group of experts, who determine if the criteria for elimination as a public health problem have been met.
On 10 June 2022, the WHO country representative, Dr George Fom Ameh, transmitted an official letter acknowledging this achievement to Equatorial Guinea's Minister of Health, Dr Diosdado Vicente Nsue Milang. The letter was signed by the Director-General of WHO, Dr Tedros Adhanom Ghebreyesus.
Elimination of gambiense HAT as a public health problem is an important step on the road to achieving the more ambitious goal of elimination of transmission. Equatorial Guinea is now committed to maintaining its surveillance capacity, to ensure that screening and diagnosis continues in populations at risk of contracting the disease. It remains committed also to ensuring that there is adequate treatment for any new cases detected, and to controlling tsetse fly populations.
