The World Health Organization (WHO) congratulates Guinea for eliminating the gambiense form of human African trypanosomiasis as a public health problem. This form of human African trypanosomiasis, the only type transmitted in Guinea, is the first neglected tropical disease to be eliminated in the country. The news marks an important achievement in this public health field on the eve of the world Neglected Tropical Diseases Day, marked on 30 January.
"Today's announcement is both a testament to the global progress against neglected tropical diseases and a beacon of hope for nations still battling human African trypanosomiasis," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
Human African trypanosomiasis (HAT), or sleeping sickness, is a vector-borne parasitic disease caused by infected tsetse flies. Symptoms include fever, headaches, joint pain and, in advanced stages, neurological symptoms like confusion, disrupted sleep patterns and behavioural changes.
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In the 1990s, HAT resurged along Guinea's coast due to increased human activity in mangroves, driven by Conakry's economic and population growth. In response to the critical threat posed by HAT, Guinea's Ministry of Health and Public Hygiene established the National Programme for the Control of HAT in 2002, with support from WHO and the Institut de Recherche pour le Développement (IRD), and later from partners such as the Drugs for Neglected Diseases initiative and the Institut Pasteur de Guinée. The programme began with mass medical screenings to diagnose and treat cases effectively, marking a crucial step in controlling the disease.
The programme introduced vector control interventions in 2012 aiming to interrupt contact between people and tsetse flies. Initially implemented in the Boffa-East area, this strategy expanded nationwide by 2016, with nearly 15 000 impregnated mini-screens (with insecticides to attract and kill the tsetse flies) deployed annually.
However, Guinea faced significant challenges in its HAT elimination efforts during the Ebola outbreak and COVID-19. From 2013 to 2015, the Ebola epidemic caused a suspension of medical activities, leading to a resurgence in HAT cases. In 2020, the COVID-19 pandemic posed further disruptions, but the programme adapted by implementing door-to-door HAT screening to maintain control efforts.
Collaboration with local communities played a critical role throughout these years, ensuring that interventions were culturally acceptable and widely supported. Advances in diagnostic techniques, treatment delivery, and consistent financial and technical backing from WHO and other partners bolstered the programme's impact. As a result, Guinea successfully reduced the number of HAT cases to below the WHO threshold of 1 case per 10 000 inhabitants in all endemic areas, achieving a major milestone in its fight against this neglected tropical disease.
"The elimination of sleeping sickness is the result of many years of effort by the Guinean government, its partners and communities in the overall context of the national policy to combat all neglected tropical diseases," said Dr Oumar Diouhé BAH, Guinea's Minister of Health and Public Hygiene.
"The elimination of human African trypanosomiasis by Guinea is a significant public health achievement. Vulnerable families and communities can now live free of the threat posed by this potentially fatal disease," said Dr Matshidiso Moeti, WHO Regional Director for Africa. "I congratulate the government, health workers, partners and communities for this crucial milestone. "WHO remains committed to supporting countries to eliminate human African trypanosomiasis and other neglected tropical diseases in Africa."
With Guinea, seven other countries have been validated by WHO for eliminating the gambiense form of human African trypanosomiasis: Togo (2020), Benin (2021), Côte d'Ivoire (2021), Uganda (2022), Equatorial Guinea (2022), Ghana (2023) and Chad (2024). The rhodesiense form of the disease has been eliminated as a public health problem in one country, Rwanda, as validated by WHO in 2022.
Note to the editor
Human African trypanosomiasis, also known as sleeping sickness is a vector-borne parasitic disease caused by infection with protozoan parasites belonging to the genus Trypanosoma. These parasites are passed to humans through the bite of infected tsetse flies, which acquire the infection from humans or animals carrying the pathogenic parasites. There are two forms of the disease: one caused by Trypanosoma brucei gambiense, found in 24 countries in West and Central Africa and which accounts for more than 92% of cases; and another caused by Trypanosoma brucei rhodesiense, found in 13 countries in East and Southern Africa accounting for the remaining cases.
The main approaches to controlling sleeping sickness include reducing the reservoirs of infection and reducing the presence of the tsetse fly. Screening of people at risk helps identify patients earlier in the disease development. If diagnosis is made early, it is possible to avoid complicated and risky treatment procedures during the advanced stage, and to improve the cure prognosis.
