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In 2012, the World Health Organisation (WHO) set out a roadmap for the control, elimination, or eradication of 17 neglected tropical diseases by 2020 [1]. Many were skeptical about the achievability of such goals. Now, still two years away from that end point, good news is emerging for gambiense human African trypanosomiasis (HAT), or sleeping sickness, caused by the tsetse-fly−transmitted protozoan parasite Trypanosoma brucei gambiense in West and Central Africa [2]. The Rhodesiense form of the disease is being pursued under a separate programme. This was the conclusion of the third WHO meeting of stakeholders on the elimination of gambiense HAT in Geneva between the 18th and 20th of April 2018, attended by representatives from national sleeping sickness control programmes, groups developing new tools to fight HAT, international and nongovernmental organisations involved in HAT control, industrial partners (Bayer Healthcare, Sanofi, and Vestergaard), and funding agencies (including the Belgian Development Cooperation and the Bill and Melinda Gates Foundation). Things have moved on substantially since the inaugural meeting of this group in 2014 [3]. The notional global target of<2,000 reported HAT cases by 2020 has already been met. Preliminary figures collated by WHO indicate that fewer than 1,500 cases were reported in 2017, although some foci remain above the threshold of 1 case or fewer per 10,000 people, and there are still some endemic areas where accessibility is limited. Reported incidence has diminished by >95% since the turn of the century [4]. This extraordinary success story is bringing the gambiense HAT elimination programme into the realms of some of the more celebrated— and better funded—programmes, such as those against Guinea worm [5] and polio [6], diseases that have been vying for the position of second human affliction, after smallpox, to be eradicated. In spite of the success, HAT does, however, remain a public health problem in some countries in which various factors conspire to limit progress. Take Guinea, for example, where the Ebola outbreak of 2014 through 2015 led to a cessation of HAT control activities and an increase in the HAT burden [7]. Appropriate funding, ownership of the HAT problem by endemic countries, and political and social stability will all be key to ensure further progress and avoid setbacks.

plos neglected tropical diseases

The elimination of human African trypanosomiasis is in sight: Report from the third WHO stakeholders meeting on elimination of gambiense human African trypanosomiasis