Human African Trypanosomiasis (HAT; sleeping sickness), is a parasitic disease caused by two related parasite strains, Trypanosoma brucei gambiense and Trypanosoma brucei rhodesiense. The HAT parasite is transmitted by the tsetse fly. Sleeping sickness is endemic to sub-Saharan Africa. It is characterized by two stages: an early hemolymphatic phase and a late encephalitic phase. If untreated, late-stage disease progresses to coma and death.
In the past century, sleeping sickness has killed millions of patients in Africa. Over the past two decades, coordinated global health efforts have reduced reported cases from more than 25,000 in 2000 to fewer than 600 in 2024. Disease vector control strategies such as “Tiny Traps” for tsetse flies and advances in treatment options have driven substantial progress, including the introduction of fexinidazole, the first all-oral treatment for sleeping sickness in 2018. However, other therapies for advanced Stage 2 disease can require complex administration and, in some cases, invasive lumbar punctures to determine disease stage and guide treatment decisions.
The development of acoziborole, a single-dose, oral curative treatment effective for both Stage 1 and Stage 2 HAT caused by the gambiense parasite, represented a significant opportunity to further simplify care and accelerate disease elimination. Developed through a collaboration between the Drugs for Neglected Diseases initiative (DNDi) and Sanofi, with funding support from the Gates Foundation, among other donors, acoziborole promised to transform the standard of care.
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