Kala-azar Elimination Support

Since the 1820s, India has been fighting Kala-azar, also known as Visceral Leishmaniasis, a severe and neglected tropical disease. The year 2023 marked a significant turning point, with reported cases dropping drastically from 9,241 in 2014 to just 520 last year. This major step towards elimination achieved the milestone of less than one case per 10,000 people in all blocks. We are at the cusp of eliminating kala-azar as a public health problem.

Most affected regions in India

Kala-azar predominantly affects the poorest regions in India, including:

  • West Bengal
  • Bihar
  • Eastern Uttar Pradesh
  • Jharkhand

These regions are home to some of the most vulnerable populations, who are at increased risk due to poor living conditions and limited access to healthcare.

Towards a Future Free of Kala-azar

Kala-azar is fatal in 95% of untreated cases, severely impacting some of the world’s poorest populations. New cases of kala-azar continue to emerge, posing significant challenges, including Post Kala-azar Dermal Leishmaniasis (PKDL), which develops in some patients after recovery harbouring Leishmania parasites in the skin. While it is not life-threatening, PKDL can be disfiguring and stigmatizing. Patients with PKDL can still transmit visceral leishmaniasis, complicating efforts to eliminate the disease.

To achieve WHO validation for elimination by 2027, sustained focus and consistent efforts are crucial in our fight against this deadly disease.

Our contribution towards eliminating kala-azar in India

1. Led a four-year study in India, confirming the safety and effectiveness of new treatments like single-dose liposomal amphotericin B (AmBisome). This research influenced health policies in India and South Asia, recommending these treatments as first-line and second-line options for VL.

2. Conducted a study in an endemic region showing that PKDL often develops 24 months after kala-azar treatment and contributes to VL transmission. These findings highlighted the importance of early PKDL treatment in VL elimination strategies.

3. DNDi is the technical partner in a study evaluating the safety and efficacy of AmBisome-MF combination therapy and AmBisome monotherapy for VL in HIV co-infected patients. Sponsored by MSF, the trial aims to guide national and regional decision-makers on the best treatment options.

Centres of Excellence (CoE)

In 2023, DNDi partnered with National Centre for vector borne disease Control Program and RMRIMS to establish Centres of Excellence in Saran and Purnea districts, Bihar, following WHO’s recommendations.

Created by refurbishing the laboratories and leishmaniasis wards in public hospitals in two districts of Bihar, the two CoEs are strengthening the capacity of the kala-azar elimination program bringing advanced care closer to at-risk populations.

Work done so far in CoEs

  • DNDi identified and fulfilled infrastructure development and HR strengthening needs
  • Upgraded and strengthened health staff capacity, trained 4300 of ASHA workers and guaranteed relevant medical supplies
  • Ensured access to appropriate diagnostics and treatment for relapse and complicated cases (VL, PKDL & VL-HIV patients)

Looking forward

All

Improved Access

Addressing the significant shortcomings of existing VL treatments such as hospitalization requirements, injectable forms, and drug-related toxicity

All

Transformative Change

Pioneering transformative changes in research and development (R&D) and improving access to treatment for affected populations.

All

Decisive Acceleration

Accelerating efforts towards the sustainable elimination of VL and PKDL through innovative treatments and strategic interventions.

DNDi’s commitment

We are dedicated to maintaining the momentum towards eliminating Kala Azar in India. With sustained support and collaboration with the Ministry of Health, state governments and CSR partnerships, we aim to keep the disease at bay and achieve WHO validation for elimination by 2027.

JOIN US

Your partnership can make a significant difference in our efforts to eliminate Kala Azar. Together, we can bring transformative change to some of the most vulnerable communities in India.

Our partners

Stories from the ground

I got kala-azar twice and was exhausted, but with the COE nearby my home, I do not need to worry anymore.

Karan Kumar, a 15-year-old from Pithauri, faced a challenging journey with kala azar. Initially misdiagnosed with typhoid in 2019, his condition worsened, and he was advised to rest. The onset of the COVID-19 lockdown further delayed his treatment. In 2023, when he fell ill again, the local Centre of Excellence (CoE) provided a solution, treating him swiftly. Despite a relapse, Karan now feels reassured with the CoE near his home.