<p></p><p>Togo has received validation from the World Health Organization (WHO)
for having eliminated human African trypanosomiasis or “sleeping
sickness” as a public health problem, becoming the first country in
Africa to reach this milestone.</p><p>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. 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.</p><p>Togo’s achievement comes after more than two decades of sustained
political commitment, surveillance and screening of cases. Beginning in
2000, the country’s public health officials implemented control
measures. In 2011, the country established surveillance sites at
hospitals in the cities of Mango and Tchamba, which cover the main areas
at risk of the disease. Public health officials have since maintained
heightened disease surveillance in endemic and at-risk areas.<strong> </strong></p><p>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.</p><p>“This validation makes Togo the first country in Africa to have
eliminated human African trypanosomiasis or sleeping sickness,” said Hon
Moustafa Mijiyawa, Minister of Health and Public Hygiene. “Thanks to
the joint efforts of all health actors, the disease has been eliminated
in Togo. Neighbouring countries are not at the same phase and so
surveillance must continue to avoid a resurgence of this disease.”</p><p>A WHO-led global collaboration 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.</p><p>“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.”</p><p>There are two forms of sleeping sickness. The first, due to <em>Trypanosoma brucei gambiense</em>, is found in 24 countries in west and central Africa and accounts for more than 98% of cases. The second form, due to <em>Trypanosoma brucei rhodesiense</em>,
is found in 13 countries in eastern and southern Africa and represents
the rest of cases. WHO and partners are targeting the elimination as a
public health problem of the <em>gambiense</em> form of the disease from
all endemic countries by 2030. Benin, Burkina Faso, Cameroon, Cote
d’Ivoire and Ghana have started the validation process with the support
of WHO.</p><p>Wiping out the <em>gambiense</em> 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.</p><div></div>
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