Sleeping Sickness Elimination in Sight Time to Celebrate and Reflect, but Not Relax 英文参考文献.docVIP

Editorial SleepingSicknessEliminationinSight:TimetoCelebrate andReflect,butNotRelax SerapAksoy* YaleSchoolofPublicHealth,NewHaven,Connecticut,UnitedStatesofAmerica Sleepingsickness,alsoknownashuman African trypanosomiasis (HAT), is one of the neglected tropical diseases of sub- Saharan Africa that has plagued human health and agricultural development. In West Africa, infection with Trypanosoma brucei gambiense gives rise to a chronic diseasethatmainlyaffectshumans.Infec- tionwithT.b.gambienseaccountsformore than 90% of reported sleeping sickness from WHO report that the number of new cases diagnosed with HAT in 2009 has dropped below 10,000 for the first time in50years, signaling apossible end to the latest epidemic cycle as a major public health problem. This decline was achievedthroughanambitious campaign led by WHO, and many nongovernmen- tal organizations (NGOs) and thanks to a public–private partnership with Sanofi- Aventis and Bayer to donate and distrib- ute the necessary drugs to WHO for use in affected countries. Without this gener- osity, patients would have no access to life-saving drugs, however unsatisfactory, given that many national health budgets arealready stretched. Anewnifurtimox/ eflornithinecombinationtreatment(NECT) was also developed recently that reduced both the cost of drugs and their delivery [3,4]. Also crucial in HAT control was the recognition of the problem by African headsofstateandgovernmentsduringthe African Union Summit in Lome′ in 2000 wherethePanAfricanTsetseandTrypano- somiasisEradicationCampaign(PATTEC) was initiated with the objective to render Africa a tsetse- and trypanosomiasis-free continent [5]. While the news of reaching a probable elimination phase for HAT is most welcoming, sustainable management of disease control now poses a formidable challenge to endemic countries and health ministriesthathavetojuggleamultitudeof diseaseswhenfacedwithshortagesoffunds. IfthedeclineinthereportedHATcasesis taken at facevalue, it