By Mary Hearty

Togo becomes the first African country to be declared free from human African trypanosomiasis, also known as “sleeping sickness”.

“This validation makes Togo the first country in Africa to have eliminated human African trypanosomiasis or sleeping sickness,” Hon Moustafa Mijiyawa, Minister of Health and Public Hygiene said.

“Thanks to the joint efforts of all health actors, the disease has been eliminated in Togo. Neighboring countries are not at the same phase and so surveillance must continue to avoid a resurgence of this disease.”

This great milestone comes after more than two decades of Togo’s sustained political commitment, surveillance and screening of cases.

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.

Since 2000, the country’s public health officials implemented control measures including establishment of surveillance sites at hospitals in the cities of Mango and Tchamba, which cover the main areas at risk of the disease.

Additionally, global collaboration led by WHO 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.”

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.

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.
There are two forms of sleeping sickness.

The first is due to Trypanosoma brucei gambiense, is found in 24 countries in west and central Africa and accounts for more than 98 percent of cases.
The second form, due toTrypanosoma brucei rhodesiense, is found in 13 countries in eastern and southern Africa and represents the rest of cases.

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.

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.

Other countries like Benin, Burkina Faso, Cameroon, Cote d’Ivoire and Ghana have started the validation process with the support of WHO.

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