Transboundary elimination - active screening for HAT in DRC using CATT test and RDT
Healthcare workers testing a woman for HAT in the DRC © FIND/J. Ndung'u

Transboundary collaboration to eliminate sleeping sickness in Angola and DRC

What is this project?

This project is focused on implementing integrated diagnosis and treatment strategies for human African trypanosomiasis (HAT, also known as sleeping sickness), in support of disease elimination efforts in the transboundary region of Angola and the Democratic Republic of the Congo (DRC).

Sleeping sickness elimination in the Democratic Republic of the Congo

Why are we working on it?

The World Health Organization (WHO) has set a target for the global elimination of HAT by 2030. HAT is endemic to 36 Sub-Saharan African countries and primarily affects people living in remote and rural areas, which has made diagnosing, treating, and monitoring the disease challenging.

FIND has been supporting efforts to eliminate HAT in the DRC since 2014 and expanded activities to Angola in 2015. Significant reduction of cases has been achieved in the region since the start of the project, notably by introducing rapid diagnostic tests (RDTs) and supporting testing in health facilities, and by deploying mobile teams to carry out active screening of populations at risk.

However, Angola has recently faced a surge of HAT cases – which might be the result of disruptions of screening programmes and health services experienced during the COVID-19 pandemic. This highlights the importance of effective and sustainable surveillance strategies to protect the gains made to date and to achieve elimination of the disease.

Number of HAT cases in the transboundary region of Angola and the DRC since the start of the project
Number of HAT cases in the transboundary region of Angola and the DRC since the start of the project

What does it involve?

Project activities are focused on strengthening diagnostic and surveillance capacity. This includes conducting training, upgrading health facilities, and making easy-to-use, reliable screening and diagnostic tools available at the primary care level – the first point at which people seek care – so that those who are found positive can rapidly be referred for confirmatory testing and receive treatment. Regular awareness-raising among healthcare workers and communities is also critical to maintaining vigilance in areas of low transmission.

Given the transboundary nature of the region, achieving the elimination goals will depend on coordinating and harmonizing activities in the two countries. The project therefore promotes collaboration and experience-sharing to protect the gains and drive further progress.

What do we expect to achieve?

This new phase of work aims to counter the setbacks caused by the COVID-19 pandemic and support the two countries in refining current approaches into integrated, cost-effective strategies that will help to achieve the elimination of HAT as a public health problem and mitigate the risk of resurgence.

The model implemented in Angola and the DRC was purposefully designed to be replicable. Other African countries, including Chad, Côte d’Ivoire, Guinea, and Uganda, have since then adopted a similar model and are making significant strides against HAT.

What is the timescale?

Support for the project in the DRC was established in 2014 and activities in Angola started in 2015. The next phase of work will run from 2023 to 2025.

Project funders

From 2014 to 2022, our work on this project was supported with funding from the Bill & Melinda Gates Foundation, UK aid from the British people, the German Federal Ministry of Education and Research (BMBF) through KfW, the Swiss Agency for Development and Cooperation (SDC), the Canton of Geneva, the Belgian Institute of Tropical Medicine (ITM), supported by the Belgian Technical Cooperation, and others, and with significant in-kind contributions by the governments of the countries. Starting 2023, the project is being funded by the Canton of Geneva and by the Bill & Melinda Gates Foundation.