NECT = Nifurtimox-Eflornithine Combination Therapy

NECT is the first new, improved treatment option in 25 years for stage 2 (advanced stage) human African trypanosomiasis (HAT) also known as sleeping sickness. It consists of a simplified co administration of nifurtimox, which is given orally, and eflornithine, which is given intravenously.

  • Launched in 2009
  • First new treatment for HAT in over 25 years
  • 14 intravenous infusions of eflornithine over seven days together with three times a day oral nifurtimox for ten days
  • Included in the Essential Medicines List (EML) of the WHO since 2009
  • Added to the Essential Medicines List for children of the WHO in 2013
  • Much safer than Melarsoprol, a highly toxic, arsenic-based drug that kills 5% of treated patients, still used in 50% of patients
  • Compared to eflornithine monotherapy, the best previously available treatment for stage 2 HAT, NECT is:
    • As effective
    • Safer
    • Easier to administer
    • More cost-effective
    • Requires shorter hospitalization
  • The result of a six-year partnership between NGOs, governments, pharmaceutical companies and WHO.
  • Free supply to endemic countries from WHO via drug donations by Sanofi and Bayer
  • Available in 13 African countries that account for 100% of reported HAT cases
  • Represents 93% of HAT treatments distributed in DRC in 2011
  • 100% of stage 2 patients treated with NECT


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Implementation progress
Available in 13 African countries Request supply signed by Congo and Guinea
Recent Scientific Publications
PLOS NTDs, November 2012
In-Hospital Safety in Field Conditions of Nifurtimox Eflornithine Combination Therapy (NECT) for T. b. gambiense Sleeping Sickness
Clinical Infectious Diseases, October 2012
Combination Therapy (NECT) for second stage gambiense
human African trypanosomiasis: MSF experience in the Democratic Republic of the Congo