The WHO delivered fexinidazole to Malawi and Zimbabwe, replacing suramin and melarsoprol in the treatment of rhodesiense human African trypanosomiasis (r-HAT). This breakthrough offers a safer and more manageable treatment option, eliminating the need for lumbar punctures. Fexinidazole is available worldwide through Sanofi, reflecting a significant advancement after decades without new therapeutics for this neglected disease.
On January 30, 2025, the World Health Organization (WHO) delivered fexinidazole to the health authorities of Malawi and Zimbabwe, signifying a pivotal advancement in the treatment of rhodesiense human African trypanosomiasis (r-HAT). This follows WHO’s recommendation in August 2024 to replace suramin and melarsoprol with fexinidazole as the primary treatment for this acute and potentially fatal disease. Historically, suramin and melarsoprol have been in use for decades, with significant risks associated with melarsoprol’s side effects.
Fexinidazole presents a simplified approach to disease management, being effective for both first and second-stage r-HAT without the need for lumbar punctures for determining disease stage in most instances. This marks the first therapeutic innovation for this neglected disease in over 76 years, providing patients with a safer option. WHO initially conducted training for medical personnel and established an active pharmacovigilance program to ensure proper deployment of fexinidazole.
Rhodesiense human African trypanosomiasis is caused by Trypanosoma brucei rhodesiense and is endemic to 13 countries in eastern and southern Africa. The disease can progress rapidly, leading to death when untreated. Over the past five years, approximately 8% of reported r-HAT cases involved T. b. rhodesiense, with the majority attributed to T. b. gambiense. Fexinidazole is generously donated by the manufacturer, Sanofi, ensuring adequate supply for affected patients globally.
Human African trypanosomiasis, commonly known as sleeping sickness, is a significant public health challenge in Africa, primarily affecting rural communities. The disease is transmitted through tsetse fly bites and can be caused by different subspecies of the Trypanosoma parasite. The rhodesiense form of the disease (r-HAT) is acute and can rapidly lead to death if untreated. With previous treatments like melarsoprol posing serious health risks, the introduction of fexinidazole provides a safer alternative for managing this life-threatening illness.
The introduction of fexinidazole marks a significant step forward in the treatment of rhodesiense human African trypanosomiasis, enhancing patient safety and simplifying treatment protocols. WHO’s delivery of this medication to Malawi and Zimbabwe represents a commitment to addressing neglected diseases effectively. Furthermore, the ongoing education and pharmacovigilance strategies implemented by WHO underscore the importance of proper treatment application and monitoring in improving health outcomes for affected individuals.
Original Source: www.who.int
