163
Good Practice
Development
Global Compact International Yearbook 2013
Sleeping sickness: A neglected tropical
disease threatening millions of people
in Africa
More than one billion people worldwide
are at risk from– or are affected by – a
group of infectious tropical diseases that
the international community considers
to be “neglected diseases.” They are called
“
neglected” because the people who are
most affected by these diseases are often
the poorest populations, living in remote,
rural areas, urban slums, and conflict
zones with poor living and hygiene
conditions. Neglected tropical diseases
persist under conditions of poverty and
are concentrated almost exclusively in
the most disadvantaged populations in
developing countries.
Without a strong political voice to address
the issue, these tropical diseases will
continue to have a low profile and a low
status in public health priorities, even
though they are endemic in 149 countries
and territories. Their consequences range
–
depending on the disease– from blind-
ness, disfiguring scars and ulcers, severe
pain, limb deformities, impaired mental
and physical development, to death.
Sleeping sickness (also known as human
African trypanosomiasis) is a parasitic dis-
ease transmitted by the bite of an infected
Glossina insect, commonly known as the
tsetse fly. If left untreated, the parasites
invade the central nervous system and
cause severe symptoms such as changes
in behavior, confusion, poor coordination,
and disturbance of the sleep cycle (which
gives the disease its name). Without treat-
ment, sleeping sickness is generally fatal.
Sleeping sickness threatens millions of
people in 36 countries in sub-Saharan
Africa. Many of the affected populations
live in remote areas with limited access
to adequate health services, making
surveillance, diagnosis, and treatment
of the disease very challenging. In cer-
tain areas, displacement of populations
due to conflict is an additional factor
favoring transmission of the disease, in
regions where health systems are weak
or non-existent.
A 1995 WHO Expert Committee esti-
mated that 60 million people were at
risk, with an estimated 300,000 new
cases per year in Africa, of which fewer
than 30,000 cases were diagnosed and
treated. During epidemics, prevalence
reached 50 percent in several villages in
the Democratic Republic of the Congo,
Angola, and Southern Sudan. Sleeping
sickness was the first or second greatest
cause of mortality in those communities,
ahead of even HIV / AIDS.
A partnership born from a
desperate situation
Despite the efforts of WHO, the situation
for sleeping sickness was becoming des-
perate in 1999 when drugs to treat the
disease were likely to be discontinued,
and manufacturing to come to an end.
However in 2000, discussions were initi-
ated between WHO and Aventis, one of
the parent companies of Sanofi, which
manufactured three of the five drugs
used to treat the disease (pentamidine,
“
Above all, this partnership shows
what is possible when a pharma-
ceutical company wants to see its
products make a difference in the
lives of impoverished people living
in remote places. In collaboration
with WHO and national control
programs, multiple challenges –
beyond the donation of drugs – have
been progressively tackled in ways
that build sustainable capacity.
The results speak for themselves.”
Dr. Margaret Chan, Director-General of
the World Health Organization
Queuing for sleeping sickness screening test
Finger prick to collect blood for screening test