WHO maintains continuous support for case detection, including support to NSSCPs for screening (passive and active) of populations at risk and confirmatory diagnosis and staging of cases, to determine the correct treatment. Reagents and equipment for screening and diagnosis are provided. Support also includes supervision and monitoring of mobile teams and sentinel sites. During the past years, WHO has supported:

• active screening including supply of diagnostic tests (card agglutination test for trypanosomiasis, CATT) in Angola, Burkina Faso, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Guinea and Uganda;
• integrated passive surveillance in sentinel sites, including supply of diagnostic tests (including a donation of rapid diagnostics tests by SD Abbott) in Angola, Benin, Burkina Faso, Cameroon, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Ghana, Guinea, Malawi, Mali, Nigeria, Rwanda, South Sudan, Togo, Uganda, United Republic of Tanzania, Zambia and Zimbabwe;
• the maintenance of a system for shipping dried blood specimens from cases of suspected HAT for remote testing in specialized WHO Collaborating Centres capable of doing trypanolysis tests, adding specificity to surveillance in low endemic areas and countries; and
• the reduction by half of the cost of the most sensitive confirmatory laboratory test in the field (mAECT) through WHO by obtaining donations of material from General Electric for the manufacture of mAECT kits in Africa.

Since 2000, more than 50 million people have been screened for HAT with more than 220 000 cases diagnosed.

WHO is the only institution that receives the donated medicines produced by Sanofi and Bayer for treatment of HAT; all requests for these medicines are channelled through WHO to ensure adequate control of their use and comprehensive capture of epidemiological information. 

WHO also ensures access to the best treatment available for all cases in whom HAT is diagnosed, and has supplied medicines to the 20 endemic countries declaring cases (Angola, Burkina Faso, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Gabon, Guinea, Kenya, Malawi, Nigeria, South Sudan, Uganda, United Republic of Tanzania, Zambia and Zimbabwe). This activity includes joint forecasting of needs for optimal production, logistics and administrative work for distribution and technical advice for the appropriate use of the medicines. At the same time the supply includes not only anti-HAT medicines but also all the material needed for its utilization (syringes, catheters, perfusions, nursing material, etc.) supplied as kits. All logistic support is provided through an agreement with MSF-Logistics.

Medicines are also supplied to medical institutions in non-endemic countries to treat cases of HAT diagnosed among travellers and migrants. In order to facilitate access to treatment of these cases, WHO, in collaboration with different institutions, has set up prepositioned stocks in the following sites:

• Antwerp (Belgium): Universitair Ziekenhuis 
• Würzburg (Germany): Department of Tropical Medicine, Missioklinik
• Rotterdam (The Netherlands): Erasmus University Medical Center
• Oslo (Norway): Medisinsk klinikk, Oslo Universitetssykehus
• Barcelona (Spain): Hospital Clinic
• Basel (Switzerland): FMH Innere Medizin, Swiss Tropical and Public Health Institute
• Liverpool (United Kingdom): Hospital, Royal Liverpool and Broadgreen University Hospital, NHS Foundation Trust
• London (United Kingdom): University College London Hospitals, NHS Foundation Trust 
• Atlanta (USA): United States Centers for Disease Control and Prevention 
• Shanghai (China): National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention
• Tokyo (Japan): Division of Infectious Diseases, Institute of Medical Science
• Johannesburg (South Africa): Netcare Milpark Hospital

Since the first agreement was signed with Sanofi and Bayer, more than 200 000 people have been treated for sleeping sickness; the disease is lethal unless treated.

WHO has published guidelines for the clinical management of HAT cases, the criteria for therapeutic choices and the details of treatment.

As WHO ensures that all HAT cases are documented in place and time, plus a few other characteristics, good epidemiological data for surveillance of the disease are generated. The data provided by the national programmes and complementary sources are included in the Atlas of HAT, which represents the main tool for monitoring the evolution of the situation at all levels, from global to village, and a resource to support the planning of field operations. 

At the same time, this database is transferred to endemic countries (Angola, Cameroon, Central African Republic, Chad, Congo, Côte d'Ivoire, Equatorial Guinea, Democratic Republic of the Congo, Gabon, Guinea, South Sudan, Malawi, Uganda, United Republic of Tanzania, Zambia), together with supplies of equipment and training in its use locally.

WHO helps national programmes to assess the local situation, identify suitable techniques and methodologies, design appropriate structures, develop adapted strategies and implement capacity‐building activities. This assistance is brought through consultation, training and support material (guidelines and other documents).

Training

Training is an essential activity to ensure that the health staff involved at different levels in control and surveillance activities have the adequate skills. This training has included:

• specific national training in diagnosis, case management and surveillance tailored to the needs of each programme; 
• training of trainers in the WHO treatment guidelines and pharmacovigilance;
• training in the use of the HAT Atlas in Kinshasa (Democratic Republic of the Congo);
• training in the Identification of villages at risk (IVR) methodology; 
• an International Course on African Trypanosomiasis (ICAT), a 3‐week training course done jointly with ATA (Association against African trypanosomiasis), for programme managers and health staff in HAT control and surveillance, facilitated by professionals with long experience in the domain. Since 2000, seven editions of this course have been organized (ICAT1-Marseille, ICAT2-Lyon, ICAT3-Lisbonne, ICAT4-Tunis, ICAT5-Nairobi, ICAT6-Kinshasa, ICAT7-Kampala), training more than 150 people from 32 countries.

Dissemination of information and raising awareness and advocacy about the disease among the international community and decision-makers in endemic countries

WHO promotes the dissemination of information and the sensitization of decision‐makers, health staff and affected populations, all of which are essential for elimination of the disease. A variety of materials have been produced and distributed.

The HAT control and surveillance programme and the results are regularly presented in the WHO website, in health journals, in specific meetings convening all HAT stakeholders and all affected countries, and at conferences and international meetings, including "national HAT day” celebrated in the Democratic Republic of the Congo on 30 January.