(a)        REPORT OF A ROUND TABLE MEETING ON THE THREAT OF MERGER OF T. B. GAMBIENSE AND T. b. rhodesiense IN UGANDA

            As a response to a request from the Ugandan government to WHO for technical support to address the threat of the merger of T. b. gambiense and T. b. rhodesiense, a round table meeting supported by WHO/TDR was held during the 28th ISCTRC in Addis Ababa, Ethiopia. A list of persons who attended this meeting is below.

            The current situation of HAT in Uganda and the epidemiological evidence of the spread were presented and discussed, and the following issues were noted, among others:

• T. b. rhodesiense is rapidly spreading northwards towards the T. b. gambiense focus.
• Merger of the two forms of the disease would create a complex epidemiological situation.
• There are weaknesses in the implementation of policies geared at preventing the spread of HAT, e.g. coordination, integration of approaches, livestock management, tsetse control
• Tools for differentiation of T. b. gambiense and T. b. rhodesiense are inadequate and need to be improved.

The papers presented during the meeting are available at ISCTRC/ IBAR

Arising out of the above, the following recommendations were made:

• In VIEW of the WHO/AFRO Regional Committee resolution (AFR/RC55/R3) of 2005, and considering the goal to eliminate human African trypanosomiasis (HAT), the 28th meeting of the International Scientific Council for Trypanosomiasis Research and Control (ISCTRC) recommends that WHO/AFRO should spearhead advocacy for and mobilization of funds through member states and governments to support implementation of the regional strategy for HAT control and prevent further spread of the disease.

• In connection with the above recommendation, and in VIEW of the threat of overlap of T. b. gambiense with T. b. rhodesiense, it is recommended that the government of Uganda, with support from development partners, should implement the following actions:

• Surveillance of the two forms of parasites in both humans and livestock in the interphase districts
• Establish the tsetse apparent density in the interphase districts
• Develop and improve available techniques for differentiation of T. b. gambiense and T. b. rhodesiense
• Map out routes of livestock movements and ensure treatment of cattle at livestock markets
• Ensure that an integrated approach for trypanosomiasis and tsetse control is implemented
• Ensure that block treatment and targeted vector control are implemented as public health interventions in epidemic situations.

• Finally, it is recommended that a follow-up meeting involving more stakeholders should be organized in Uganda within one year. List of participants