TAG: GS 3: SCIENCE AND TECHNOLOGY
THE CONTEXT: The World Health Organization (WHO) launched a comprehensive framework on June 12, aimed at eradicating visceral leishmaniasis (VL), commonly known as kala-azar, in eastern Africa.
EXPLANATION:
- This initiative is in response to the rising threat posed by the parasitic infection, which has become a significant public health concern in the region.
Kala-azar
- Kala-azar, or visceral leishmaniasis, is a severe parasitic disease characterized by fever, weight loss, and enlargement of the spleen and liver.
- There are 3 main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose and throat).
- Leishmaniasis is caused by protozoan parasites which are transmitted by the bite of infected female phlebotomine sandflies.
- The disease affects some of the world’s poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system and lack of financial resources.
- An estimated 700 000 to 1 million new cases occur annually.
- Only a small fraction of those infected by parasites causing leishmaniasis will eventually develop the disease.
- It can be fatal if not treated promptly.
- The disease is transmitted through the bite of infected female sandflies and is endemic in 80 countries worldwide.
- In 2022, eastern Africa accounted for 73% of the global VL caseload, with 50% of these cases occurring in children under the age of 15.
- Historically, between 2004 and 2008, Bangladesh, India, and Nepal were responsible for 70% of the global VL cases.
- However, by October 2023, WHO declared Bangladesh as the first country to eradicate VL, thanks to rigorous eradication programs initiated in 2005.
- The success in Asia was attributed to a regional strategic framework, accelerated elimination programs, strong political commitment, and sustained stakeholder support.
New Framework for Eastern Africa
- The new WHO framework for eastern Africa aims to replicate the success achieved in Asia.
- This initiative targets nine countries in the region that account for three-fourths of the global incidence of kala-azar.
- The framework offers a comprehensive approach for these countries to implement strategies, monitor progress, identify gaps, and build capacity to combat the disease.
Key Strategies for VL Elimination
- The WHO framework outlines five main strategies to guide VL elimination efforts:
- Early Diagnosis and Treatment: Ensuring timely diagnosis and treatment to reduce mortality and morbidity associated with the disease.
- Integrated Vector Management: Controlling the population of sandflies to prevent the spread of the disease.
- Effective Surveillance: Implementing robust surveillance systems to monitor and track the incidence and spread of VL.
- Advocacy, Social Mobilization, and Partnership-Building: Engaging communities, stakeholders, and policymakers to support elimination efforts.
- Implementation and Operational Research: Conducting research to improve strategies and address challenges in the eradication process.
Implementation and Regional Targets
- The framework also details a stepwise process for implementing the elimination phases, setting clear regional targets.
- These targets include:
- A 90% reduction in VL incidence in the eastern Africa sub-region to fewer than 1,500 cases per year by 2030.
- Detection and treatment of 90% of VL cases within 30 days of the onset of symptoms by 2030.
- A 100% reduction in VL deaths among children by 2030.
Significance and Expected Outcomes
- The WHO framework is expected to provide crucial direction to the affected countries in eastern Africa.
- It aims to generate momentum and ensure coordinated efforts towards the elimination of VL.