[Status of sleeping sickness in 2003]

On May 3, 2001, the World Health Organization signed a major agreement with the pharmaceutical industry for the supply of drugs necessary for treatment of sleeping sickness. At that time Dr. Gro Harlem Brutland, director of the WHO, announced, "We can now look forward to halting the spread of sleeping sickness...". The purpose of this article is to take a look at the situation two years later. A first assessment showed that most national programs for the control of human African trypanosomiasis (NPCHAT) had practically become inoperative. One of the first steps in the new eradication campaign consisted of reviving these NPCHAT teams. However this goal could be achieved only insofar as awareness of the severity of the disease and of the need to act was felt at every level of decision-making. In 2001 the Pan-African Tse-Tse Trypanosomiasis Eradication Campaign (PATTEC) initiative was launched by African State leaders to promote special attention at the ministerial level, high-level training, and international cooperation sometimes involving several NPCHAT teams. Actions in the field include trials using new strategies, expert assistance for personnel throughout the duration of prospection, and screening and immediate treatment of numerous patients in outbreak areas where the disease was thought to be extinct. Although progress has not always been measurable in concrete terms, the dynamics have shifted almost everywhere.