[Technical reasons for the re-emergence of sleeping sickness].

In the 1920s the epidemic outbreak of human African trypanosomiasis was so deadly that government authorities decided to take large-scale action. It was by giving Jamot absolute administrative and financial autonomy to apply his ideas that the disease was successfully controlled. After Jamot determined efforts against the disease continued so that, by the dawn of decolonization, many considered the problem of sleeping sickness as resolved. Control programs progressively slowed and virtually ceased. Neglected and all but forgotten, the disease has able to make a natural and forceful comeback. Obvious attempts have been made to explain this comeback in terms of poor commitment on the part of health authorities, disappearance of competent work groups, and lack of money and personnel. True as these issues may be, it is just not that simple. Many other problems prevent disease management from being delegated to primary healthcare workers including the difficulty of clinical, serological, and parasitological diagnosis, inability to implement effective widespread vector control, paucity of therapeutic modalities, and irrationality of vaccination. Under these conditions, re-emergence of the disease was unavoidable and future control efforts will be difficult.