Delivering on Promises? The Impact of Kinetoplastid Genomics on Sleeping Sickness, Chagas Disease and Leishmaniasis

Species of the genera Trypanosoma and Leishmania are protozoan parasites responsible for a series of neglected tropical diseases. The people most affected by these parasites are the poorest living in tropical and subtropical regions of the world. Two subspecies of Trypanosoma brucei, T. b. gambiense and T. b. rhodesiense, are the causative agents of human African trypanosomiasis or sleeping sickness. Millions of people living in 36 sub-Saharan countries are at risk of acquiring the disease.(WHO 2010a) Due to increased control over the last decade, the number of reported cases has declined to under 10,000 in 2009 for the first time in 50 years (WHO 2010a). For chemotherapy, only four drugs (suramin, pentamidine, melarsoprol and eflornithine), of which three were developed >60 years ago, and one drug combination therapy (eflornithine/nifurtimox) are available (WHO 2010a; Steverding 2010). In addition, all drugs have major drawbacks including poor efficacy, significant toxicity, need for parental administration and drug resistance (Fairlamb 2003; Matovu et al. 2001; Delespaux and de Koning 2007).