Malawi has taken a historic step in the fight against Rhodesiense sleeping sickness, a rare but deadly disease spread by the tsetse fly. For the first time, patients can take Fexinidazole Winthrop, an oral pill, instead of enduring toxic IV treatments that previously had a 5-10% fatality rate.

The disease, officially known as human African trypanosomiasis (HAT), attacks the central nervous system, leading to brain damage, coma, and death. Malawi has been one of the hardest-hit countries, with outbreaks between 2019 and 2021 revealing major gaps in treatment. Even tourists on safari have been infected, highlighting the widespread risk.

The new drug, approved in late 2024 and introduced in early 2025, treats both early and advanced stages of the disease, offering a safer and more accessible solution. Dr. Westain Nyirenda, who led clinical trials, called it a “historic achievement”, emphasizing that it moves treatment from hospitals to communities, giving patients a real chance to survive.

Developed through a public-private partnership, the drug was funded by DNDi, Sanofi, EDCTP2, and other organizations. However, climate change is worsening the problem, expanding the tsetse fly’s habitat and increasing human-animal contact, making future outbreaks more likely.

While efforts have eliminated the gambiense form of sleeping sickness in eight countries, including Guinea, the rhodesiense strain remains harder to control because it also infects cattle and wild game.

Still, health officials remain optimistic. Dr. Junior Matangila of DNDi stated, “With oral drugs like Fexinidazole Winthrop, we now have a powerful new tool to turn the tide.”

This breakthrough could save countless lives across East and Southern Africa. What do you think about this medical advancement?

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