Abstract
BackgroundOver the last few years, momentum has gathered around the feasibility and opportunity of eliminating gambiense human African trypanosomiasis (g-HAT). Under the leadership of the World Health Organization (WHO), a large coalition of stakeholders is now committed to achieving this goal. A roadmap has been laid out, and indicators and milestones have been defined to monitor the progress of the elimination of g-HAT as a public health problem by 2020. Subsequently, a more ambitious objective was set for 2030: to stop disease transmission. This paper provides a situational update to 2012 for a number of indicators of elimination: number of cases annually reported, geographic distribution of the disease and areas and populations at different levels of risk.ResultsComparing the 5-year periods 2003-2007 and 2008-2012, the area at high or very high risk of g-HAT shrank by 60%, while the area at moderate risk decreased by 22%. These are the areas where g-HAT is still to be considered a public health problem (i.e. > 1 HAT reported case per 10,000 people per annum). This contraction of at-risk areas corresponds to a reduction of 57% for the population at high or very high risk (from 4.1 to 1.8 million), and 20% for moderate risk (from 14.0 to 11.3 million).DiscussionImproved data completeness and accuracy of the Atlas of HAT enhanced our capacity to monitor the progress towards the elimination of g-HAT. The trends in the selected indicators suggest that, in recent years, progress has been steady and in line with the elimination goal laid out in the WHO roadmap on neglected tropical diseases.
Highlights
Thanks to the efforts of a wide range of stakeholders, as well as to the commitment of countless field workers in affected countries, the elimination of gambiense human African trypanosomiasis (g-HAT) seems achievable.In 2001, when the number of infected people was reaching alarming levels [1], the World Health Organization (WHO) and its partners launched a public-private partnership that, combined with the efforts of NGOs and bilateral cooperation, resulted in enhanced disease control and a sizable reduction in the number of cases
Comparing the 5-year periods 2003-2007 and 2008-2012, the area at high or very high risk of g-HAT shrank by 60%, while the area at moderate risk decreased by 22%
For 2008–2012, 43.4 million people out of a total of 56.4 million at risk lived in areas at low or very low risk of infection, and they have met the criterion of elimination as a public health problem (i.e. < 1 case per 10,000 inhabitants per year)
Summary
Thanks to the efforts of a wide range of stakeholders, as well as to the commitment of countless field workers in affected countries, the elimination of gambiense human African trypanosomiasis (g-HAT) seems achievable. In 2001, when the number of infected people was reaching alarming levels [1], the World Health Organization (WHO) and its partners launched a public-private partnership that, combined with the efforts of NGOs and bilateral cooperation, resulted in enhanced disease control and a sizable reduction in the number of cases. Further progress was made in decreasing the number of reported cases, until in 2011 the WHO Strategic and Technical Advisory Group on Neglected Tropical Diseases (NTDs) judged that the elimination goal was achievable. Over the last few years, momentum has gathered around the feasibility and opportunity of eliminating gambiense human African trypanosomiasis (g-HAT). This paper provides a situational update to 2012 for a number of indicators of elimination: number of cases annually reported, geographic distribution of the disease and areas and populations at different levels of risk
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