Medical: Human African trypanosomiasis (Sleeping Sickness)

© Juan Carlos Tomasi

During the first stage of the illness, people have non-specific symptoms such as fever and weakness. At this stage the disease is difficult to diagnose but relatively easy to treat. The second stage occurs once the parasite invades the central nervous system. The infected person begins to show neurological or psychiatric symptoms, such as poor coordination, confusion, or convulsions and sleep disturbance.

Accurate diagnosis of the second stage of the illness requires taking a sample of spinal fluid and treatment is painful, requiring daily injections. The most common drug used to treat trypanosomiasis, melarsoprol, was developed in 1949 and has many side-effects. A derivative of arsenic, it is highly toxic and fails to cure up to 30 per cent of patients in some areas of Africa. It also kills up to five per cent of people who receive it. Though eflornithine is somewhat difficult to administer because it has to be given intravenously and requires a complicated treatment schedule, it is a safer alternative and is used by MSF in its projects.

In 2009, a new treatment option called NECT (Nifurtimox-Eflornithine Combination Therapy) was added to the World Health Organization's Essential Medicines List, based on the application submitted by the non-profit Drugs for Neglected Diseases initiative (DNDi) and supported by Epicentre and MSF. Some studies have demonstrated that NECT, a co-administration schedule of oral nifurtimox and intravenous eflornithine, is a better treatment option for people with advanced-stage sleeping sickness, because it is safer than melarsoprol and easier to use than eflornithine.

MSF admitted more than 1,900 patients for treatment for human African trypanosomiasis in 2008.