A new single-dose oral treatment for sleeping sickness, known as Acoziborole, is being tested in children in the Democratic Republic of Congo and Guinea, according to a March 17 announcement. The drug has already shown promise in adults and could simplify efforts to eliminate the disease across Africa.
Sleeping sickness, or human African trypanosomiasis (HAT), is a parasitic infection spread by tsetse flies. Without treatment, it is usually fatal. The most common form of the disease is found across Central and West Africa. In 1998, around 40,000 cases were reported on the continent, with more than 300,000 others estimated to have gone undetected and untreated.
Traditional treatments for HAT have required multiple doses delivered through intravenous infusions or intramuscular injections and often necessitate hospitalization. These methods also require patients to return for both diagnosis and treatment—a challenge in remote areas with poor infrastructure. Lack of cold chain facilities, trained medical staff for injections, and local hospitals are significant barriers to care.
Acoziborole changes this approach by allowing health workers to test and treat patients in a single encounter without specialist equipment. The drug consists of three tablets taken once in one day and works across both early- and late-stage disease. It eliminates the need for lumbar punctures previously required before starting treatment.
The development of Acoziborole builds on over two decades of research following earlier treatments such as NECT introduced in 2009 and fexinidazole in 2018. According to Mutombo: "We really needed to go as close as possible to the affected people so as to eliminate sleeping sickness, and Acoziborole allows us to do this." He added that success will depend on securing national registrations for the drug and maintaining disease surveillance.
Jean-Mathieu Bart from Guinea's National Programme for the Control of Neglected Tropical Diseases said: "We have seen that it is a very safe and effective drug." Bart noted that while Guinea eliminated HAT as a public health problem last year, "It is obvious that Acoziborole will help us accelerate the elimination of transmission by 2030." However, he emphasized that vector control—reducing tsetse fly populations—and community awareness remain essential alongside treatment: "It is the combination of protect, sensitise, test and treat pillars that we will continue."
