In 2012, a team of scientists in Guinea took a significant step toward combating sleeping sickness, also known as Human African Trypanosomiasis (HAT). On the banks of the Fatala River in western Guinea, they deployed small blue fabric targets coated with insecticide to attract and kill the tsetse fly, the disease’s vector. The results were groundbreaking: a reduction in the prevalence of sleeping sickness in the region. By 2024, the country had made tremendous progress, with only 12 reported cases of the disease, down from being the country with the highest number of cases in West Africa in the early 2000s. This success culminated in January 2025, when the World Health Organization (WHO) declared that sleeping sickness had been eliminated as a public health problem in Guinea.
Sleeping sickness is transmitted through the bite of an infected tsetse fly, which carries the Trypanosoma parasite. The disease primarily affects rural communities, especially those involved in agriculture and fishing. Its symptoms include fatigue, skin rashes, sleep disorders, and, if untreated, it can be fatal. The Gambian variant, endemic in West and Central Africa, is responsible for most cases, while the Rhodesian variant, which is more prevalent in East and Southern Africa, accounts for a smaller portion.
For years, controlling the disease in Guinea proved difficult. Between 2007 and 2012, mass screening and treatments were employed, but the number of cases remained stubbornly high. This led researchers to shift their focus to controlling the tsetse fly population. The introduction of the “tiny targets,” blue fabric screens that attracted and killed the flies, became a critical tool. These devices proved effective without harming the broader ecosystem, significantly reducing the presence of the tsetse fly in the affected areas.
However, the efforts to control the disease were briefly interrupted by the 2013 Ebola outbreak, which overwhelmed the country’s healthcare system. Despite this, communities continued to deploy the blue targets, and when the teams returned to the area in 2016, they discovered that areas with the targets had no new cases of sleeping sickness, while other regions had seen a sharp rise in infections.
By incorporating vector control into its strategy, Guinea was able to reduce the number of cases significantly. The WHO, which had previously focused mainly on diagnosing and treating the disease, adjusted its guidelines to include vector control as a key tool in the fight against sleeping sickness.
In addition to vector control, advances in treatment have been pivotal in the battle against the disease. Prior to 2009, the treatment for sleeping sickness was extremely toxic, often resulting in severe side effects. A safer treatment, NECT, was introduced in 2012, but it still required lengthy hospitalizations. In 2018, the approval of fexinidazole, a pill taken at home, represented a major breakthrough, making treatment more accessible, especially in rural areas. Currently, research continues on new treatments, with acoziborole, a single-dose oral medication, showing promise for further simplifying and improving the treatment process.
Public awareness campaigns have also been a critical element of Guinea’s success. Radio programs, such as the one run by Radio Communautaire Forecariah, have helped spread information about the disease and its symptoms, making it easier for medical teams to reach people in remote areas. Local health workers and community members have also played an essential role in detecting and reporting cases.
While the elimination of sleeping sickness as a public health problem in Guinea is a significant achievement, the journey is not over. The next goal, set by the WHO for 2030, is to reach zero transmission, meaning no new cases over a five-year period. Despite the progress, recent cases, like the two new ones reported in January 2025, show that the fight against the disease is ongoing. Nonetheless, Guinea’s success offers hope for other countries in the region and serves as a model for combating neglected tropical diseases through a combination of innovation, community involvement, and global cooperation.
