Report of the third WHO stakeholders meeting on rhodesiense human African trypanosomiasis

Overview

2020 is the year set in the roadmap on neglected tropical diseases (NTDs), published by the World Health Organization (WHO) in 2012, as the target for elimination of human African trypanosomiasis (HAT) as a public health problem. In the London Declaration on NTDs, pharmaceutical companies, donors, endemic countries and nongovernmental organizations also committed themselves to meeting this goal. Joint work since 2000 resulted in 2018 in fewer than 1000 cases reported globally, a historically low number. Important milestones are being reached in achieving the goal of eliminating HAT as a public health problem by 2020.

Elimination efforts have focused on gambiense HAT (g-HAT), which is responsible for most (about 98%) reported cases. Rhodesiense HAT (r-HAT) is chronically neglected. The low number of reported cases fails to attract the interest of donors and r-HAT is thus of low priority for health decision-makers, despite its epidemic potential. Domestic and wild animal reservoirs make the control of r-HAT more complex. The One Health approach involving numerous sectors beyond human health, such as veterinary services, vector control, tourism and management services of protected areas, is the way forward to reach the set goals.

The first WHO stakeholders meeting on r-HAT elimination (Geneva, 20–22 October 2014) boosted the multisectoral coordination mechanism between WHO and partners to eliminate r-HAT as a public health problem. Contributing partners included members of academia, public–private partnerships, nongovernmental and international organizations, donors and national sleeping sickness control programmes. The second stakeholders meeting (Geneva, 26–28 April 2017) reviewed progress and identified essential activities for the future such as sustained surveillance, multisectoral coordination and partnerships, innovative methods and tools for control, and improving capacity-building.

This third stakeholders meeting took place as the first roadmap on NTDs (2015–2020) was almost concluded and the new roadmap on NTDs (2021–2030) was being prepared. It was the time to share the achievements, challenges and views on the goal of elimination among participating countries and implementing partners, and to advance the process of validation of elimination and strengthening of surveillance systems in order to detect any re-emergence of the disease before reaching epidemic levels again.