Chad eliminates sleeping sickness as a public health problem

In a landmark achievement, Chad has become the first country in 2024 and the 51st globally to eliminate a neglected tropical disease (NTD) — the gambiense form of human African trypanosomiasis (HAT), also known as sleeping sickness. This announcement by the World Health Organization (WHO) marks a significant victory in the ongoing fight against these debilitating diseases that primarily affect low-income populations.

HAT is caused by protozoan parasites that spread via infected tsetse flies. The illness is typically fatal if left untreated, according to the WHO. For centuries, sleeping sickness has devastated communities across sub-Saharan Africa. If not treated, the disease progresses slowly, causing fatigue, headaches and, in severe cases, coma. 

There are two forms of HAT, determined by the subspecies of the parasite involved: Trypanosoma brucei gambiense, which accounts for 92 per cent of reported cases and Trypanosoma brucei rhodesiense, responsible for the remaining 8 per cent.

Read more: Togo first in Africa to end sleeping sickness

Prior to 2002, Chad faced a significant burden of sleeping sickness, particularly in the Mandoul region. However, a dedicated national effort, in collaboration with WHO and other partners, launched a multi-pronged attack on the disease.

The strategy focused on two key areas:

• Early diagnosis and treatment
• Tsetse fly control

Early diagnosis and treatment involved improving access to healthcare in remote areas, which allowed for faster identification of cases. Additionally, the introduction of new, more effective and easier-to-administer drugs for HAT treatment significantly improved patient outcomes.

Tackling the insect vector tsetse was crucial to breaking the transmission cycle. Chad implemented a targeted programme using traps and insecticides specifically designed to attract and kill tsetse flies.

These combined efforts yielded impressive results. Case numbers dropped dramatically, with no new infections reported in recent years. However, elimination requires rigorous verification. 

WHO meticulously reviewed data on case surveillance, diagnostic testing and vector control measures. After a thorough assessment, Chad was officially declared to have eliminated gambiense sleeping sickness as a public health problem in April 2024.

This achievement is a testament to Chad’s unwavering commitment to public health and its strong collaboration with international organisations. It serves as an inspiration for other countries battling NTDs. The success story also highlights the importance of targeted interventions, improved diagnostics and community engagement in tackling these neglected diseases.

Read more: Tsetse fly genes yield clues to control sleeping sickness

While celebrating this milestone, vigilance remains crucial. Continued surveillance and control measures are essential to prevent the resurgence of sleeping sickness. Additionally, Chad can now turn its focus towards eliminating other NTDs prevalent in the country.

The global fight against NTDs continues, with a target of eliminating at least 100 of these diseases by 2030. Chad’s success story paves the way for a future free from the burden of neglected tropical diseases, offering hope for millions living with these debilitating conditions.

To date, WHO has validated the elimination of the gambiense form of HAT in seven countries: Togo (2020), Benin (2021), Ivory Coast (2021), Uganda (2022), Equatorial Guinea (2022), Ghana (2023) and Chad (2024). Additionally, the rhodesiense form of the disease has been eliminated as a public health problem in Rwanda.