Sleeping sickness (human African trypanosomiasis) is a lethal parasitic infection transmitted by tsetse flies. After a peak of around 40,000 reported cases in 1998 and many more likely undetected, sustained control reduced confirmed cases to fewer than 600 by 2024. Remaining infections tend to be in remote, hard-to-reach locations.
Acoziborole Winthrop (acoziborole), developed by Sanofi with DNDi, has been recommended for approval by the European Medicines Agency’s Committee for Medicinal Products for Human Use on 27 February. Phase 2 and Phase 3 human trials in the DRC and Guinea, published in The Lancet Infectious Diseases, showed up to 96% success at 18 months across early and late stages.
The treatment is a single oral dose of three tablets taken once, and it removes the need for a lumbar puncture to stage the disease. That change allows test-and-treat approaches so health workers can diagnose and treat in one visit, unlike older therapies such as the injectable arsenic derivative Melarsoprol and other regimens that required repeated injections, hospital stays and follow-up visits.
Acoziborole is currently recommended for adults and adolescents aged at least 12 years and weighing over 40 kg; a paediatric trial (ACOZI-KIDS) in children aged one to 14 is underway in the DRC and Guinea. Sanofi will manufacture and donate doses to WHO, but national regulatory approvals are still needed, and experts stress that drug access must be combined with vector control and community awareness to accelerate interruption of transmission by 2030.
Difficult words
- parasitic — caused by an organism living on another
- transmit — to pass a disease from one to anothertransmitted
- sustain — to keep something continuing over timesustained
- lumbar puncture — medical procedure to take fluid from spine
- regimen — a planned course of medical treatmentregimens
- test-and-treat — approach to diagnose and treat in one visit
- vector control — actions to reduce animals that spread disease
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How might a single-dose, test-and-treat approach improve care in remote, hard-to-reach locations?
- Why do experts say drug access should be combined with vector control and community awareness to interrupt transmission by 2030?
- What practical obstacles mentioned in the article could delay access to the drug even after international approval and donation?
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