A review from Institut Pasteur in Paris and Institut Pasteur of Guinea argues that the diagnostic bottleneck for human African trypanosomiasis is likely to intensify as elimination progresses and parasite loads fall. It highlights the promise of CRISPR-based tools as a next diagnostic layer to close the gap between screening and treatment in remote endemic areas. The review contrasts gambiense and rhodesiense disease biology and notes that conventional approaches struggle with low parasitemia and that asymptomatic infection could sustain transmission. It frames CRISPR approaches as potentially more sensitive alternatives across serology, parasitology, and molecular testing limitations. For developers and public-health partners, the main near-term need is validation of operational performance—sensitivity, specificity, and deployment workflow—under real-world elimination-era conditions.