Sleeping sickness: time for dreaming

For a long time, the treatment of human African trypanosomiasis (HAT) represented for clinicians a journey through time, to the sources of colonial tropical medicine. [...]2018, the drugs available (apart from eflornithine), were commercialised during the first half of the 20th century.1 The pharmaceutical industry had no financial motivation to seek new products for a disease with a market representing a few tens of thousands of cases per year, living in rural and impoverished regions of sub-Saharan Africa. [...]at the end of the eradication process when human disease will be rare, the animal reservoir might sustain human infections, which might explain the persistence of low incidence in countries where, assuming a reproduction number lower than 1, the disease should have already disappeared.6 Could acoziborole be useful as a veterinary drug, given as mass treatment to all domesticated animals in the residual foci, once a year for 2 or 3 years, with the addition of an attractive scent for each species? Some logistical effort would be required to ensure that each animal ingests a single dose of acoziborole within a given interval, but token compensation for owners who bring animals might be useful (in two regions of the Democratic Republic of the Congo where I lived, a typical village would only hold a few dozen goats and dogs, but usually no pigs or sheep; thus, a day of work would be sufficient to treat all animals).