Suramin Availability in Australia
Suramin is not commercially available in Australia through standard pharmaceutical channels, but can potentially be accessed through special access schemes for the treatment of first-stage rhodesiense human African trypanosomiasis (sleeping sickness).
Current Status and Access Pathways
Suramin remains an approved treatment for first-stage rhodesiense HAT in children younger than 6 years or with bodyweight less than 20 kg, as fexinidazole has not been studied in this population 1.
In non-endemic countries like Australia, suramin would need to be obtained through:
- Special Access Scheme (Category A or B) from the Therapeutic Goods Administration (TGA)
- Emergency importation protocols for rare tropical diseases
- Direct contact with WHO or specialized tropical disease centers
The 2025 WHO guidelines note that pentamidine is more likely to be available than suramin in non-endemic countries, as pentamidine is also used for Pneumocystis jirovecii pneumonia treatment 1.
Clinical Context for Use
For patients requiring suramin in Australia:
First-stage rhodesiense HAT is the primary indication where suramin remains necessary, particularly for young children 1.
When oral fexinidazole absorption is uncertain (critical illness, inability to swallow), suramin may be preferred for first-stage disease 1.
Immediate treatment is critical given the rapid progression of rhodesiense HAT; if suramin is unavailable, interim pentamidine treatment should be initiated while arranging access to first-line drugs 1.
Important Caveats
Suramin has been replaced by fexinidazole as first-line therapy for most patients with rhodesiense HAT (age ≥6 years, weight ≥20 kg) 1.
The drug has significant toxicity, including dose-dependent polyneuropathy, and requires careful monitoring 2.
Suramin is not registered for any other indication in Australia, despite historical research into cancer and other conditions 3, 4, 5.
For suspected HAT cases in Australia, immediate consultation with infectious disease specialists and tropical medicine centers is essential to arrange appropriate drug access and treatment.