HAT elimination update

1. HAT elimination update

2. Measuring progress towards elimination • Main quantitative indicators : • Number of cases reported • Number of foci reporting less than 1 case per 10,000 inhabitants (to be calculated from 2015 onwards) • To be updated annually • Secondary indicators to assess the quality and extent of the elimination: • Geographical extent of the disease • Progress of population at different levels of risk • Population at risk covered by control and surveillance activities • To be updated every two years

3. Number of cases reported

4. Number of cases reported

5. Geographical extent of the disease

6. Geographical extent of the disease

7. Progress of population at different levels of risk

8. Progress of population at different levels of risk

9. Area at risk Total: 1,28 million km2 Total: 1,15 million km2

10. Population at risk Total: 52.7 million Total: 55.0 million

14. Pop at risk potentially covered VH-H: Very high and high risk M : Moderate risk L-VL: Low and very low risk

15. Pop at risk potentially covered VH-H: Very high and high risk M : Moderate risk L-VL: Low and very low risk

16. Pop at risk potentially covered VH-H: Very high and high risk M : Moderate risk L-VL: Low and very low risk

17. Key events since last STAG • December 2013: WHO Expert Committee Meeting on Control and surveillance of HAT and Technical report published and endorsed by Executive Board • Strategy for HAT elimination defined • March 2014: First WHO stakeholders meeting on gambiense HAT elimination

18. 1st WHO stakeholders meeting on gambiense HAT elimination • Meeting organized by WHO, 25-27 March 2014 in Geneva • 70 participants from: • National Control Programmes (SSNCP) of Angola, Cameroon, CAR, Chad, Côte d’Ivoire, DRC, Guinea, South Sudan, Uganda • International organizations: African Union (AU) / PATTEC, FAO, IAEA, PAAT, WHO (HQ and AFRO and also including WHO NTD STAG) • Foundations and NGOs: DNDi, FIND, MSF (including MSF-CAME) • Scientific institutions and academia: Erasmus MC / University Medical Centre of Rotterdam, INRB Kinshasa, IRD, ITM Antwerp, LSTM and University of Liverpool, MakerereUniversity Kampala, SEEG University of Oxford, STPHI, University of Glasgow. • Donors: Bayer HealthCare, BMGF, DGD Belgium, Sanofi, The Wellcome Trust.

19. Issues • Progress, challenges and strategy for gambiense HAT elimination • Critical technical gaps in gambiense HAT elimination to be addressed by research and development, and advances in the last years • Screening and diagnostics tools, • New drugs, • Epidemiological aspects and • Vector control. • Concept of HAT elimination, mechanisms for monitoring and evaluation of the elimination process as well as validation of outcomes. • Mechanisms of collaboration and coordination among stakeholders to better support disease-endemic countries

20. Conclusions and recommendations • The countries and stakeholders are congratulated on the outstanding achievements in the control of HAT for the last 15 years • The group endorses the strategy for elimination of gambiense HAT and confirms its commitment to the target expressed in the WHO NTD roadmap. • Developments ongoing in diagnostics and treatments are highly promising and it is expected to make significant contributions to the elimination strategy. Nevertheless as the number of cases decreases, there will be major challenges in organizing future clinical trials • Integration of activities in health services and the national ownership of the control programmes are key issues in the sustainable elimination of the disease. • There is consensus for moving forward as a network towards HAT elimination under the leading of WHO.

21. Declaration for the elimination of gambiense human African trypanosomiasis 28 March 2014 | Geneva Human African trypanosomiasis (HAT), commonly known as sleeping sickness, has been one of the great scourges of mankind. The incidence of gambiense HAT, which had been brought to virtual elimination in the 1960s, surged to epidemic proportions by the end of the 20th century. Efforts towards intervention in this disease over the past decade have enjoyed remarkable success with incidence falling by over 90%. New tools to diagnose and treat the disease and to control the vector are becoming available, and unprecedented political will has led to WHO declaring a programme of global elimination of this disease at a meeting in Geneva on 25-27 March 2014. WHO included HAT in its roadmap for elimination and control of neglected tropical diseases in 2012, setting a date of 2020 to eliminate the disease as a public health problem. An Expert Committee met in April 2013 and approved a strategy to eliminate the disease, subsequently endorsed by the World Health Assembly in a resolution adopted in 2013 (WHA66.12), providing an international mandate to work towards elimination. The stakeholders present at the meeting making this declaration included national sleeping sickness control programmes, groups developing new tools to fight HAT, international and non-governmental organizations involved in control and donors. The meeting decided to establish a network under WHO leadership to ensure coordinated, strengthened and sustained efforts to eliminate the disease. The stakeholders appeal to the international community and disease endemic countries for their commitment, political support and essential resources to achieve the elimination goal.

22. Declaration for the elimination of gambiense human African trypanosomiasis 28 March 2014 | Geneva Human African trypanosomiasis (HAT), commonly known as sleeping sickness, has been one of the great scourges of mankind. The incidence of gambiense HAT, which had been brought to virtual elimination in the 1960s, surged to epidemic proportions by the end of the 20th century. Efforts towards intervention in this disease over the past decade have enjoyed remarkable success with incidence falling by over 90%. New tools to diagnose and treat the disease and to control the vector are becoming available, and unprecedented political will has led to WHO declaring a programme of global elimination of this disease at a meeting in Geneva on 25-27 March 2014. WHO included HAT in its roadmap for elimination and control of neglected tropical diseases in 2012, setting a date of 2020 to eliminate the disease as a public health problem. An Expert Committee met in April 2013 and approved a strategy to eliminate the disease, subsequently endorsed by the World Health Assembly in a resolution adopted in 2013 (WHA66.12), providing an international mandate to work towards elimination. The stakeholders present at the meeting making this declaration included national sleeping sickness control programmes, groups developing new tools to fight HAT, international and non-governmental organizations involved in control and donors. The meeting decided to establish a network under WHO leadership to ensure coordinated, strengthened and sustained efforts to eliminate the disease. The stakeholders appeal to the international community and disease endemic countries for their commitment, political support and essential resources to achieve the elimination goal.