In this article, we propose a history of Médecins Sans Frontières's control activities to fight human african trypanosomiasis. Through this history are enlightening medical innovations in the scope of diagnostic and treatment of the disease. MSF investing will focus successively on (1) epidemiological and clinical diagnosis, (2) existing drugs evaluation and (3) development of new therapeutic protocols. After a period of isolation, MSF will have to cooperate with others international health organizations. Specific questions on medical practice and research in the south countries will represent the major issues regarding medical innovation.