Major Step Toward Disease Elimination
Eastern Africa has taken a major step toward eliminating visceral leishmaniasis (VL), also known as kala-azar, a deadly parasitic disease that affects thousands of people every year. A new framework, developed by the World Health Organization (WHO) in collaboration with health ministries and global partners, outlines a comprehensive strategy to eliminate VL as a public health threat by 2030. The disease, transmitted through the bite of infected female sandflies, causes fever, weight loss, enlarged spleen and liver, and, if left untreated, can be fatal. In 2022, Eastern Africa accounted for 73% of global VL cases, with half of these cases occurring in children under 15 years old.
The newly launched elimination framework presents a structured plan to combat the disease by focusing on five core strategies. These include early diagnosis and treatment to ensure rapid medical intervention, integrated vector management to control sandfly populations, and effective surveillance systems to track cases and outbreaks. Additionally, the framework highlights the importance of advocacy, social mobilization, and partnerships to raise awareness and strengthen collaboration. It also prioritizes operational research and innovation to develop better treatments and intervention methods. With these strategies in place, the framework aims to reduce VL cases in Eastern Africa by 90%, bringing them down to fewer than 1,500 per year by 2030. Other key targets include detecting and treating 90% of cases within 30 days of symptom onset, eliminating VL-related deaths among children, and ensuring all VL-HIV patients receive antiretroviral therapy.
The launch of this initiative has been welcomed by global health experts, with Dr. Saurabh Jain, WHO Focal Point for VL, emphasizing its significance. He noted that the framework provides countries with tailored tools and strategies, creating a solid foundation for sustained progress in eliminating VL. The initiative was co-developed by WHO, DNDi (Drugs for Neglected Diseases Initiative), and health ministries from nine high-burden African countries, including Chad, Djibouti, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan, and Uganda. At the official launch event in Ethiopia, government representatives, researchers, the African Union, private sector leaders, and funding organizations gathered to discuss implementation strategies and reaffirm their commitment to eliminating VL. Ethiopia’s State Minister of Health, Dr. Dereje Duguma, highlighted the framework’s importance, stating that it would offer crucial guidance to countries in the region and provide the necessary momentum to achieve elimination goals.
Eastern Africa’s elimination efforts follow the successful model implemented in Asia, where Bangladesh, India, and Nepal once accounted for 70% of global VL cases. Due to a regional strategic framework and strong government action, WHO announced in 2022 that Bangladesh had become the first country to eliminate VL as a public health problem. Inspired by this success, the Eastern Africa framework provides a structured approach for nations to assess progress, address gaps, and implement targeted strategies.
Research and innovation will play a critical role in ensuring the success of this initiative. Professor Samuel Kariuki, Eastern Africa Director for DNDi, stressed the need for continuous investment in new tools and treatments. VL remains a severe disease that primarily affects vulnerable populations, including children and people in impoverished communities. The framework’s focus on innovation aligns with DNDi’s mission of developing safer, more effective, and patient-friendly treatments. Current VL treatments, though effective, can be difficult to administer and have potential toxicity, making them less suitable for widespread use in primary healthcare settings. Advancements in treatment options will be essential to overcoming these challenges and sustaining elimination efforts.
This new framework builds on commitments made during the Nairobi Declaration in January 2023, where Eastern African health ministers pledged to eliminate VL by 2030. The initiative also aligns with WHO’s Roadmap for Neglected Tropical Diseases 2021–2030, a global strategy aimed at eliminating diseases that disproportionately affect vulnerable populations. Stronger partnerships, sustained political commitment, and continuous research will be necessary to reach the ambitious goal of eliminating VL in Eastern Africa. With the right strategies in place, this initiative has the potential to save thousands of lives and significantly reduce the burden of visceral leishmaniasis in the region.