(African Development Bank policy research document 1)
The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without health aid. It also presents a theoretic...al model of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
Between 2000 and 2014, malaria control efforts were scaled up and worldwide deaths were cut in half. But declining health aid and deprioritized vertical aid (as for malaria), despite its potentially great efficiency, have led to rising numbers of cases. In 2016, 216 million cases of malaria were reported, up from 211 million in 2015. Africa was home to 90% of all malaria cases and 91% of malaria deaths in 2016. Progress appears to have stalled in the global fight against the disease.
more
Human African trypanosomiasis is caused by Trypanosoma brucei gambiense in West and Central Africa and by T. brucei rhodesiense in East Africa; both species are endemic in Uganda. Trypanosoma brucei gambiense accounts for 98% of all cases of African trypanosomiasis, and T. brucei rhodesiense account...s for 2%. African trypanosomiasis has been targeted for eradication by the World Health Organization (WHO) and, as a result of control efforts, there has been a dramatic decrease (> 95%) in the number of reported cases worldwide.
Professional version as well as patient education
more
DNDi’s long-term goal for sleeping sickness, also known as human African trypanosomiasis (HAT), is to develop and register two new drugs that are effective against both Stage 1 and Stage 2 of the disease and both subspecies of the parasite, T.b. gambiense and T.b. rhodesiense. T.b. rhodesiense is ...an acute form of the disease, occurring primarily in Eastern and Southern Africa. Better treatments for T.b. rhodesiense sleeping sickness are urgently needed.
more
L’Atelier de mise en œuvre de partenariat constitue une étape importante pour les Partenariats africains pour la sécurité des patients. Les équipes de chaque hôpital africain, suisse et anglais participant au programme ont assisté à l’atelier
dans le but de travailler ensemble dans leur...s partenariats afin de créer des projets de programme destinés à une mise en œuvre sur les deux prochaines années. Le personnel interne clé de l’OMS et les partenaires de la NPSA
(Agence nationale pour la sécurité des patients – Londres, Angleterre) et de THET (Groupe d’experts en éducation et santé tropicale) étaient également présents.
more
Plus de 700 000 personnes perdent la vie par suicide chaque année. La réduction d’un tiers du taux mondial de mortalité par suicide d’ici à 2030 est à la fois un indicateur et une cible (la seule pour la santé mentale) dans les objectifs de développement durable des Nations Unies et dans ...le Plan d’action global de l’OMS pour la santé mentale 2013–2030. Le treizième programme général de travail 2019–2023 de l’OMS comprend le même indicateur avec une réduction de 15 % à l’horizon 2023.
Le monde n’est pas sur la bonne voie pour atteindre les cibles de la réduction du suicide fixées pour 2030. L’OMS encourage les pays à prendre des mesures pour prévenir le suicide, idéalement par le biais d’une stratégie nationale intégrée de prévention du suicide. Les gouvernements et les communautés peuvent contribuer à la prévention du suicide en mettant en œuvre l’approche LIVE LIFE de l’OMS, dont le but est de servir de base pour commencer la prévention du suicide, et dont ils peuvent s’inspirer pour élaborer une stratégie nationale intégrée de prévention du suicide. Le présent guide s’adresse à tous les pays, qu’ils disposent actuellement ou non d’une stratégie nationale de prévention du suicide.
more
This document focuses on the management of patients affected by gambiense HAT and
constitutes an update to the WHO therapeutic guidance issued in 2013. The main changes in recommendations concern the criteria and methods for deciding the treatment among the new set of therapeutic options and the pa...rticular conditions that apply to treatment with fexinidazole, as outlined below. Because HAT is a serious, life-threatening disease and because the efficacy of fexinidazole depends on swallowing the medicine after an appropriate intake of food as well as on completing the full 10-day
treatment schedule, the recommendations regarding fexinidazole administration are considered key elements that must be carefully followed. When the conditions listed in these guidelines are not met for any individual patient, the alternative available treatments should be prescribed.
more
Arsenical monotherapies were previously very successful for treating human African trypanosomiasis (HAT).
Melarsoprol resistance emerged as early as the 1970s and was widespread by the late 1990s.
Melarsoprol resistance represents the only example of widespread drug resistance in HAT patients wher...e the genetic mechanism has been established.
The current goal of elimination of HAT as a public health problem by 2020 may be undermined by the emergence and spread of resistance to current or new drugs.
Insights into potential resistance mechanisms for current and new drugs will facilitate predictions of the likelihood of resistance and will also facilitate rational approaches to minimizing, monitoring, and tackling the future emergence of resistance.
more
Treatment of second-stage gambiense human African trypanosomiasis relied on toxicarsenic-based derivatives for over 50 years. The availability and subsequent use of eflornithine,initially in monotherapy and more recently in combination with nifurtimox (NECT), has drasticallyimproved the pro...gnosis of treated patients. However, NECT logistic and nursing requirementsremain obstacles to its deployment and use in peripheral health structures in rural sub-SaharanAfrica. Two oral compounds, fexinidazole and SCYX-7158, are currently in clinical development.The main scope of this article is to discuss the potential impact of new oral therapies to improvediagnosis-treatment algorithms and patients’access to treatment, and to contribute to reach theobjectives of the recently launched gambiense humanAfrican trypanosomiasis elimination program
more
The twentieth century ended with human African trypanosomiasis (HAT) epidemics raging across many parts of Africa. Resistance to existing drugs was emerging, and many programs aiming to contain the disease had ground to a halt, given previous success against HAT and the competing priorities associat...ed with other medical crises ravaging the continent. A series of dedicated interventions and the introduction of innovative routes to develop drugs, involving Product Development Partnerships, has led to a dramatic turnaround in the fight against HAT caused by Trypanosoma brucei gambiense. The World Health Organization have been able to optimize the use of existing tools to monitor and intervene in the disease. A promising new oral medication for stage 1 HAT, pafuramidine maleate, ultimately failed due to unforeseen toxicity issues. However, the clinical trials for this compound demonstrated the possibility of conducting such trials in the resource-poor settings of rural Africa.
more
The development of this target product profile (TPP) was led by the WHO Department of Control of Neglected Tropical Diseases (NTD) following standard WHO guidance for TPP development. In order to identify and prioritize diagnostic needs, a WHO NTD Diagnostics Technical Advisory Group (DTAG) was form...ed, and different subgroups were created to advise on specific NTDs, including a subgroup working on the human African trypanosomiasis (HAT) diagnostic innovation needs. This group of independent experts included leading scientists, public health officials and endemic-country end-user representatives. Standard WHO Declaration of Interest procedures were followed. A landscape analysis of the available products and of the development pipeline was conducted, and the salient areas with unmet needs were identified.
more
FIND and Standard Diagnostics (SD) have developed a lateral flow rapid diagnostic test (RDT) to screen for
T.b. gambiense HAT that is cheap and easy to use. The tests are packed individually and are stable at 40°C for
up to 25 months; they are performed on fresh blood obtained from a finger prick..., and no instrument or electricity is required. The RDT detects host antibodies to infection in populations that are at risk, or in suspect individuals. Positive cases are subjected to further confirmatory methods to identify HAT patients.
more
The development of this target product profile (TPP) was led by the WHO Department of Control of Ne-
glected Tropical Diseases (NTD) following standard WHO guidance for TPP development. In order to
identify and prioritize diagnostic needs, a WHO NTD Diagnostics Technical Advisory Group (DTAG)
was... formed, and different subgroups were created to advise on specific NTDs, including a subgroup
working on the human African trypanosomiasis (HAT) diagnostic innovation needs. This group of in-
dependent experts included leading scientists, public health officials and endemic-country end-user rep-
resentatives. Standard WHO Declaration of Interest procedures were followed. A landscape analysis of
the available products and of the development pipeline was conducted, and the salient areas with unmet
needs were identified
more
Sleeping sickness is a neglected tropical disease affecting rural communities in sub-Saharan Africa. The reduction in the number of reported cases in recent years indicates that disease transmission is under control. However, many aspects of patient management still need to be improved. Undiagnosed ...patients or inappropriate treatment due to an incorrect determination of the disease stage could in fact lead to its re-emergence. There is thus a strong need for new diagnostic and staging tools to keep the disease under control and to improve the clinical care of patients. This review describes the most promising biomarkers proposed so far for the diagnosis and stage determination of patients suffering from sleeping sickness, with a particular emphasis on their translation into diagnostic tools for field applications.
more
Human African Trypanosomiasis, also known as sleeping sickness is a devastating parasitic disease. It is a neglected tropical disease affecting communities in Africa. In this video we take a look at the disease, how it presents and and ways to control it.
Over the past twenty years, huge efforts made by a broad coalition of stakeholders curbed the last epidemic and brought the disease to the brink of elimination. In this paper, the latest figures on disease occurrence, geographical distribution and control activities are presented. Strong evidence in...dicates that the elimination of sleeping sickness ‘as a public health problem’ by 2020 is well within reach. In particular, fewer than one thousand new cases were reported in 2018, and the area where the risk of infection is estimated as moderate, high or very high has shrunk to less than 200,000 km2. More than half of this area is in the Democratic Republic of the Congo. The interruption of transmission of the gambiense form, targeted by the World Health Organization (WHO) for 2030, will require renewed efforts to tackle a range of expected and unexpected challenges. The rhodesiense form of the disease represents a small part of the overall HAT burden. For this form, the problem of under detection is on the rise and, because of an important animal reservoir, the elimination of disease transmission is not envisioned at this stage.
more
Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT ...control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
more
This technical report presents the epidemiology of human and animal leishmaniases in the EU and its neighbouring countries and concludes that the disease remains widespread and underreported in many countries of southern Europe, northern Africa, and the Middle East and that there is a need to improv...e leishmaniasis prevention and control based on robust surveillance in humans, animals, and vectors, and to increase public awareness following a one health approach.
more
In 2012, the World Health Organisation (WHO) set out a roadmap for the control, elimination, or eradication of 17 neglected tropical diseases by 2020. 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 A...frican trypanosomiasis (HAT), or sleeping sickness, caused by the tsetse-fly−transmitted protozoan parasite Trypanosoma brucei gambiense in West and Central Africa. The Rhodesiense form of the disease is being pursued under a separate programme.
more
To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric...a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
more
Promoting health and preventing disease is a critical component of the effort required to achieve Universal Health Coverage (UHC). to date, efforts to achieve UHC have focused mostly on strengthening health systems and their capacities to provide curative care. However, experience from the COVID-19 ...pandemic has reaffirmed the need for resilient health systems, emphasizing primary health care, including preventive and promotive health and well-being.
Emerging from the eye of the storm as the global health lead agency during the pandemic, WHO is equipped with the required insights and actions for a holistic approach to “building back fairer and better” after COVID-19.
The Healthier Populations (UHP) Cluster in the African Region is designed to support Pillar 3 of WHO’s 13th Global Programme of Work (GPW13) which aims to make 1 billion people healthier by reducing health inequities, preventing diseases and injuries, addressing health determinants, and promoting partnerships for collaborative actions amongst all stakeholders.
more