Lomé/Brazzaville
– Togo has received validation from the World Health Organization (WHO) for
having eliminated human African trypanosomiasis or “sleeping sickness” as a
public health problem, becoming the first country in Africa to reach this
milestone.
Sleeping
sickness is caused by parasites which are transmitted by infected tsetse flies
and is only found in 36 countries in sub-Saharan Africa. If left untreated
sleeping sickness is almost always fatal. In 1995, about 25 000 cases were
detected, about 300 000 cases were estimated to have gone undetected, with 60
million people estimated to be at risk of infection. In 2019, fewer than 1000
cases were found. Togo has not reported any cases in the past 10 years.
Togo’s
achievement comes after more than two decades of sustained political
commitment, surveillance and screening of cases. Beginning in 2000, the
country’s public health officials implemented control measures. In 2011, the
country established surveillance sites at hospitals in the cities of Mango and
Tchamba, which cover the main areas at risk of the disease. Public health
officials have since maintained heightened disease surveillance in endemic and
at-risk areas.
Togo
first applied for certification of elimination of sleeping sickness in 2018 and
a team of WHO experts studied the data, made recommendations and requested a
revision by the country before giving their approval.
“This
validation makes Togo the first country in Africa to have eliminated human
African trypanosomiasis or sleeping sickness,” said Hon Moustafa Mijiyawa,
Minister of Health and Public Hygiene. “Thanks to the joint efforts of all
health actors, the disease has been eliminated in Togo. Neighbouring countries
are not at the same phase and so surveillance must continue to avoid a
resurgence of this disease.”
A
WHO-led global collaboration supported these efforts by facilitating the
donation of medicines and resources from pharmaceutical companies, which helped
strengthen local capacity and ensure the sustained availability of tools
required to control the disease.
“Togo
is a pathfinder in eliminating sleeping sickness, a disease which has
threatened millions of Africans,” said Dr Matshidiso Moeti, WHO Regional
Director for Africa. “I congratulate the Government and people of Togo for
showing the way. I am sure the country’s efforts will inspire others to push
towards a final eradication of sleeping sickness.”
There
are two forms of sleeping sickness. The first, due to Trypanosoma brucei
gambiense, is found in 24 countries in west and central Africa and accounts for
more than 98% of cases. The second form, due to Trypanosoma brucei rhodesiense,
is found in 13 countries in eastern and southern Africa and represents the rest
of cases. WHO and partners are targeting the elimination as a public health
problem of the gambiense form of the disease from all endemic countries by
2030. Benin, Burkina Faso, Cameroon, Cote d’Ivoire and Ghana have started the
validation process with the support of WHO.
Wiping
out the gambiense form of sleeping sickness will require maintaining the
commitment of endemic countries and of donors as well as integrating control
and surveillance activities into the regular health systems. These efforts need
to be supported by improved tools, innovative disease control approaches and
effective coordination of efforts.