An MSF Sleeping Sickness ward in Tambura, Sudan
© Juan Carlos Tomasi
Frequently known as sleeping sickness, this parasitic infection is seen in sub-Saharan Africa and is transmitted by tsetse flies. More than 90 per cent of reported cases of sleeping sickness are caused by the parasite Trypanosoma brucei gambiense. The parasite attacks the central nervous system, causing severe neurological disorders and leading to death if untreated.
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.
In the field, MSF doctors are constantly frustrated by the lack of adequate medical tools. In response, Médecins Sans Frontières set up the MSF Access Campaign in 1999 to improve access to existing medical tools and to stimulate the development of urgently needed better tools. Campaign for Acces to Essential Medicines.
MSF is well known for its humanitarian medical work, but it has also produced important research based on its field experience with vulnerable populations. This website archives MSF's scientific articles and makes them available free, with full text, and in an easily searchable format. MSF Field Research website.
For 30 years, MSF has directly witnessed the human cost of the lack of drugs for neglected diseases and has raised its voice against this inequity. In 2003, seven organisations from around the world joined forces to establish DNDi, Drugs for Neglected Diseases Initiative.