Perspectives in research on and control of African trypanosomiasis.

African trypanosomiasis affects both man and his domestic animals, and is fatal if untreated. The risk of epidemics makes the disease a major public health problem in 36 sub-Saharan African countries, where some 50 million people are at risk of contracting the disease. Continued suppression of the disease through medical surveillance is indispensable to prevent epidemics which are difficult and costly to control. Recent epidemics and flare-ups have occurred in certain countries due to breakdown in medical surveillance occasioned by political, social and economic factors. The development of new tools through research over the last decade has improved the diagnosis of patients and vector control. The development of eflornithine (DFMO) for the treatment of gambiense sleeping sickness is a major breakthrough in view of its safety compared with current treatment alternatives, and it has been nicknamed the 'resurrection drug'. In spite of these achievements, however, there is no radical solution to the problem of sleeping sickness. The use by the endemic countries of improved tools for disease control depends upon the availability of resources from national, bilateral and multilateral sources, and commitment of the countries concerned.