CANNES, France — DNDi is a nonprofit organization dedicated to researching and developing treatments accessible to neglected populations worldwide. With international partnerships and funding from public and philanthropic sources, the organization has provided accessible, affordable treatment options for more than 20 years. In collaboration with the Democratic Republic of the Congo (DRC), DNDi has been developing, testing, and distributing a new drug called Acoziborole since 2010. The drug treats human African trypanosomiasis (sleeping sickness) as a single dose and has success rates up to 96%, making it a groundbreaking discovery for African health care. Here is everything to know about this new treatment for sleeping sickness, including firsthand information from an interview with Dr. Junior Matangila, head of HAT Diseases at DNDi.
What is Sleeping Sickness?
Human African trypanosomiasis, more commonly known as sleeping sickness, is endemic to sub-Saharan Africa. Infected tsetse flies transmit the disease. These vectors acquire the disease from animals that carry the parasite Trypanosoma brucei, and humans can contract sleeping sickness when the flies bite them.
Sleeping sickness is extremely common in impoverished communities due to their close contact with the flies, and their living and sanitary conditions often leave them vulnerable to fly bites. Sadly, these communities rarely have the means to afford or access the health care they need, putting their lives at risk, as well as those around them.
Symptoms emerge in two phases. During the haemolymphatic (first) stage, patients often experience symptoms such as headaches, fevers, swollen lymph nodes and joint pain. In the meningo-lymphatic (second) stage, the illness progresses rapidly and causes changes in behavior and coordination, disturbances of the sleep cycle, and confusion.
There are two forms of sleeping sickness. Trypanosoma brucei gambiense accounts for 92% of reported cases and causes a slow to develop and long-lasting (chronic) illness, with symptoms remaining dormant for up to a few years after infection. By contrast, Trypanosoma brucei rhodesiense accounts for 8% of reported cases and causes a quick to develop and short-lived (acute) illness, with symptoms appearing within a few weeks to a few months after infection.
The insights below are drawn from a direct interview with Dr. Junior Matangila. Matangila joined DNDi in 2022, serving as senior medical manager until his appointment to head of HAT Diseases in 2024. He studied at the University of Kinshasa in the Democratic Republic of the Congo before pursuing a Master of Science in One Health Molecular Biology at the Sokoine University of Agriculture, Tanzania, and then obtaining a Ph.D. in Malaria Prevention at the University of Antwerp, Belgium. He now specializes in tropical infectious diseases. Alongside teaching tropical medicine at the University of Kinshasa, he conducts critical, life-saving research that tackles major health challenges, such as malaria, trypanosomiasis, Ebola and COVID-19.
What is Acoziborole?
Acoziborole is a single-dose treatment comprised of three 320mg tablets for sleeping sickness and presents a game changer for how doctors approach treating the disease. The drug originated from a compound researchers identified at Anacor Pharmaceuticals in the United States; DNDi then developed it in collaboration with the pharmaceutical company Sanofi, the biotechnology company Scynexis, and Pace University.
How Was the Drug Tested?
According to Matangila, researchers conducted several stages of testing before approving Acoziborole for use. He said the drug underwent extensive preclinical research before undergoing “Phase I studies to assess safety in healthy volunteers and a pivotal Phase II/III clinical trial conducted in 2016 and 2020 in the Democratic Republic of the Congo and Guinea in partnership with national sleeping sickness control programs.”
Testing produced remarkable results: follow-up appointments with patients 18 months post-treatment revealed success rates of up to 96%. Due to the drug’s clear success, the DRC registered Acoziborole in June 2026, following a positive opinion from the European Medicines Agency in February of that year — an application Sanofi helped coordinate given its two decades of partnership with DNDi on sleeping sickness treatments. Health providers now use the drug and distribute it to all countries where the disease is endemic.
How is the Drug Being Distributed?
DNDi, which has historically sought to ensure equitable access to health care for all patients, has collaborated with the World Health Organization to distribute the drug successfully to impoverished and remote populations free of charge.
Because this new treatment for sleeping sickness is a one-dose regimen, Matangila believes it “has the potential to significantly facilitate deployment in remote and hard-to-reach communities,” explaining that “logistical challenges associated with previous treatment regimens that required prolonged administration or hospitalization” are no longer present.
Each patient requires only one dose, administered once, which keeps production and distribution of the treatment cheap and easy through the World Health Organization’s distribution mechanisms. This direct and strong approach to eliminating sleeping sickness demonstrates DNDi’s firm commitment to eliminating the disease as a public health risk, but also emphasizes how important it is for health organizations to focus on impoverished communities, who often cannot afford or access life-saving health care.
DNDi’s Commitment to Eliminating Sleeping Sickness
Matangila stated that “DNDi remains firmly committed to supporting the World Health Organization’s goal of eliminating gambiense sleeping sickness as a public health problem and interrupting transmission by 2030.” He explained that beyond introducing Acoziborole as a new treatment and a major milestone in this fight, DNDi intends to collaborate with the World Health Organization, national programs, research institutions, and implementation partners to support all strategies and steps that contribute to the sustainable elimination of the disease.
The development of Acoziborole marks a monumental turning point in the fight against sleeping sickness. By replacing complex and prolonged medical regimens with a simple, one-dose oral tablet, DNDi and its global partners have removed the massive logistical and economic barriers that left impoverished sub-Saharan communities vulnerable. Backed by high efficacy rates and free distribution through the World Health Organization, this new treatment for sleeping sickness delivers life-saving health care directly to the most remote communities, bringing the goal of eliminating gambiense sleeping sickness by 2030 firmly within reach.
– Ruby Fraser
Ruby is based in Cannes, France and focuses on Global Health and Politics for The Borgen Project.
Photo: Pixabay