Aventis Pharma has committed US$ 25 million to support WHO’s activities in the field of African Trypanosomiasis over a five-year period. The project involves three related efforts:

• Drug donation: Aventis Pharma will arrange for the production of three key pharmaceuticals in the amounts forecast by WHO. These pharmaceuticals are pentamidine, melarsoprol and eflornithine, which are each essential for treating sleeping sickness. The drugs will be donated to WHO which, on recommendation of a group of WHO appointed experts, will conduct six-month reviews of the amounts needed to treat the disease and approve requests for drugs.

WHO will arrange for the distribution of the drugs by the medical humanitarian organization Médecins sans Frontières (MSF). Aventis will thus ship all drugs produced to MSF. MSF will then distribute the drugs, in accordance with WHO’s directions, to national control programmes and nongovernmental organizations (working in association with national authorities). These national control programmes and nongovernmental organizations (including MSF) will be able to submit requests for the drugs to WHO for approval.

As part of a corporate commitment to support this major health initiative, Bristol-Myers Squibb has agreed to fund the cost of supplying the bulk material for the production of 60,000 vials (approximately a one-year supply) of eflornithine.

• Disease management and control: With the financial support of Aventis Pharma, WHO intends to accelerate disease surveillance and control activities in the most affected countries of Africa, supporting existing and new programmes in countries, as well as linking their efforts to the international sleeping sickness network. It is intended that disease management will involve:

• the strengthening of national control programmes through training, assessment and follow-up activities;
• the renovation and re-equipping of already-established treatment centres where these exist in or near affected communities;
• the strengthening of health teams that will reach remote and unserved communities, screening and diagnosing people potentially affected;
• the reinstitution of regular surveillance and mapping activities in regions known or suspected to be susceptible to trypanosomiasis; and
• surveillance of drug resistance.

Aventis Pharma’s contribution will also allow WHO to conduct public-awareness programmes throughout the most affected nations.

• Research and development: With the financial support of Aventis Pharma, WHO, through the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (WHO/TDR), will arrange and support new research into African trypanosomiasis, focusing on adaptation of current treatments for ease of use, development of new route of synthesis for an existing drug, and development of existing molecules for future treatment.

"We can now look forward to halting the spread of sleeping sickness," said Dr Gro Harlem Brundtland, WHO Director-General. "As we increase surveillance, treatment and research, there is now reason to hope that we can better control this disease."

"We are deeply gratified by the impressive commitment of Aventis to this cause. We hope that others, inspired by our work, will join us, as much remains to be done," she added.

"We are delighted to have forged this partnership with the World Health Organization and to play an important role in combating this dreaded disease. This partnership is an example of a public-private partnership wanting to find viable solutions for life-threatening diseases," said Richard J. Markham, Chief Executive Officer of Aventis Pharma. "We are committed to playing an important role in improving the quality of human life and contributing to the sustainable development of our world."

Both WHO and Aventis commend nongovernmental organizations, especially MSF, for the public awareness raised on sleeping sickness affecting poor African countries. WHO will continue to seek new governmental, institutional and corporate partners to accelerate the war against sleeping sickness.

Human African trypanosomiasis is becoming increasingly more prevalent after it had been close to being eliminated in the early 1960s. It is a parasitic infection transmitted by the tsetse fly. Eventually, it affects the central nervous system, causing severe neurological disorders and, if left untreated, it invariably causes the death of the person affected. It is estimated that only about 10% of those suffering from this disease currently receive proper treatment. A number of reasons, including armed conflicts in endemic countries as well as the higher visibility of other diseases in the international community, have led to a dramatic decrease in systematic population screening, which is necessary to control the disease.

Human African trypanosomiasis takes two forms, depending on the parasite involved:

• Trypanosoma brucei gambiense (T.b. gambiense) is found in central and West Africa. It causes chronic infection. A person can be infected for months or even years without obvious symptoms of the disease emerging. When symptoms do emerge, the disease is already at an advanced stage and, without treatment, leads to death.

• Trypanosoma brucei rhodesiense (T.b. rhodesiense) is found in southern and east Africa. It causes acute infection that emerges after a few weeks. It is more virulent than the other strain and develops more rapidly, which means that it is more quickly detected clinically and has a more rapid progression to death if untreated.

The main affected African countries include Angola, Cameroon, Central African Republic, Chad, Congo, Côte d’Ivoire, Democratic Republic of Congo, Guinea, Sudan and Uganda. With this agreement, WHO expects to be able to re-start control programmes in countries such as Ghana, Liberia, Kenya, Nigeria, Sierra Leone and the United Republic of Tanzania, where the risk of African trypanosomiasis is high but where control activities have been scant in recent years. WHO also looks forward to working with all the other countries that are endemic for or at risk from African Trypanosomiasis.