Access activities for fexinidazole continued throughout 2022, including in additional countries where the drug has been adopted as the first-line treatment for sleeping sickness caused by T.b. gambiense. Training on the new treatment guidelines was completed. Using fexinidazole as an example, the team is now concentrating on improving routine pharmacovigilance reporting in five countries (Democratic Republic of the Congo [DRC], Central African Republic, Guinea, Angola, and South Sudan). In the DRC, these efforts provided an opportunity for DRC’s National Centre for Pharmacovigilance (CNPV) to raise awareness on pharmacovigilance reporting more broadly, stimulating reporting on adverse events for drugs other than fexinidazole.

In addition, the results of an ethnographic study conducted in the DRC to understand how various factors shape communities’ knowledge, perceptions, and behavior related to sleeping sickness were published in the journal Diseases.

In 2021, FEX-g-HAT focused on strengthening health system capacity to use fexinidazole as a first-line treatment for sleeping sickness caused by T.b. gambiense (g-HAT) and to monitor patients treated with the new drug. In Angola, Central African Republic (CAR), Democratic Republic of the Congo (DRC), Guinea, and South Sudan, DNDi and consortium partners delivered trainings on fexinidazole treatment guidelines, supervised pharmacovigilance activities, and worked to reinforce national pharmacovigilance systems with support from the HAT Platform. These activities aim to facilitate sustainable reporting to accompany full introduction of the new treatment and adoption of revised treatment guidelines in all countries. Despite the challenges presented by the COVID-19 pandemic, g-HAT-endemic countries succeeded in increasing access to fexinidazole as a first-line treatment.

In 2020, training activities of health care providers were carried out focussing on serological screening, updating new HAT treatment guidelines and pharmacovigilance, to support improved detection and early treatment of gambiense sleeping sickness. Activities to ensure effective tracking and to facilitate access to fexinidazole were also undertaken.

Furthermore, in the DRC, 26 focal points from three regional pharmacovigilance centres have been trained.