22 August 2025 Press releases

Boost for sleeping sickness elimination efforts led by ITM

In a major step toward eliminating sleeping sickness in the Democratic Republic of the Congo (DRC), the Institute of Tropical Medicine (ITM) has secured a 17.5 million dollar grant from the Gates Foundation. The funding will support the GAMBIT project, which aims to intensify efforts against this fatal parasitic disease.

Sleeping sickness cases have dropped by 97% in the last 20 years. But as the numbers decline, detecting the remaining cases becomes more difficult.
The three-year GAMBIT project aims to accelerate elimination of sleeping sickness in the DRC and lay the groundwork for a ‘screen-and-treat’ approach using a new drug.
GAMBIT is a collaboration between ITM, the Congolese National Sleeping Sickness Control Program (PNLTHA), the Congolese National Institute for Biomedical Research (INRB), and the Liverpool School of Tropical medicine (LSTM) to build sustainable impact and support the WHO’s goal of eliminating sleeping sickness by 2030.

We are at a tipping point. The yield of screening is getting lower, communities are getting discouraged, and the parasite is waiting for its chance to strike back. Thanks to funding from the Gates Foundation, we can now turn the tide for good.

Elena Nicco, infectious diseases expert at ITM

The GAMBIT project

The project builds on four pillars: active screening, population participation, vector control, and diagnostic capacity.

At the heart of the project is the preparation for a ‘screen-and-treat’ approach, set to launch in 2029. The idea is simple: mobile teams visit communities in remote areas and carry out an on-the-spot rapid screening test for antibodies against the parasite. Anyone who tests positive immediately receives treatment with acoziborole, a safe, single-dose oral drug. This approach eliminates the need for hospital stays or complex testing. This low-threshold approach makes it possible to reach a much larger group, even before the disease is confirmed by a laboratory test or before symptoms appear. Because humans are the only host in which the disease can survive, this makes elimination possible.

The strategy is currently being tested in the north of the DRC through StrogHAT, an ITM-led clinical trial evaluating its safety, feasibility, and effectiveness.

The DRC is closer than ever to eliminating sleeping sickness. With the tools and partnerships in place, we are preparing the ground for full-scale implementation of the screen-and-treat strategy by 2029 and to reach even the most remote communities.

Dr Erick Miaka, director of the PNLTHA

International cooperation

Despite substantial progress, the final stages of elimination remain fragile. Sustained political commitment and continued donor investment are essential to achieve zero cases, avoid resurgence and ensure a smooth handover of program responsibility to the national level.

The GAMBIT project is a joint effort led by ITM in close collaboration with Congolese and international partners. It builds on years of progress supported by funding from the Gates Foundation, Belgium’s Directorate-General for Development Cooperation (DGD), the World Health Organization (WHO), and the European Union.

The StrogHAT project is funded by Horizon Europe and supported by the Global Health EDCTP3 Joint Undertaking and its members.

Belgium is recognized as a global leader in sleeping sickness elimination, thanks to ITM’s century-long expertise and its sustained work in the DRC, the disease’s main stronghold. Alongside WHO’s goal to halt transmission by 2030, ITM and its partners are committed to making sleeping sickness a disease of the past.