African trypanosomiasis, commonly known as sleeping sickness, remains a persistent public health challenge in many parts of sub-Saharan Africa, particularly in rural areas. The disease is caused by Trypanosoma brucei and transmitted by the tsetse fly (Glossina spp.), the disease presents a complex relationship of biomedical, ecological, and socio-economic factors that demand an integrated response. This chapter explores sustainable health practices in the management and control of African trypanosomiasis, with a focus on building resilient, community-based care systems. The paper identified the existing diagnostic and therapeutic frameworks, gaps in accessibility, affordability, and long-term effectiveness in endemic regions. The chapter encourages a model of care rooted in sustainability, emphasizing the decentralization of services, the strengthening of local health infrastructure, and the integration of health education into disease control efforts. Furthermore, the chapter also highlighted innovative and environmentally sound vector control strategies that align with ecological conservation and community participation. The relevance of a One Health approach is emphasized and its role in improving surveillance and disease reduction. Finally, the paper connects sustainable trypanosomiasis management to global sustainable development goals (SDGs), highlighting its implications for poverty alleviation, food security, and health equity. Thus, by advancing locally owned, adaptable, and eco-conscious strategies, this chapter offers a blueprint for long-term disease control and sustainable health system development in rural areas in many developing countries.