India’s ambition to eliminate visceral leishmaniasisBMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g6671 (Published 07 November 2014) Cite this as: BMJ 2014;349:g6671
- Talha Burki, journalist, London
In 2005 India signed a memorandum of understanding with Nepal and Bangladesh, undertaking to eliminate visceral leishmaniasis, also known as kala azar, as a public health problem by 2015. Elimination was defined as an incidence of less than one case in 10 000 people at district level. This was an arbitrary figure, borrowed from the campaign against leprosy and epidemiologically meaningless. But it had political cachet, and while the previous Congress government that signed the memorandum seemed to lose interest in the disease, the Bharatiya Janata Party (BJP), which took over earlier this year, has reinvigorated efforts. The BJP renewed the international commitment, and at a high level meeting in Patna, Bihar, on 2 September 2014 the minister of health Harsh Vardhan unveiled a roadmap for tackling kala azar,1 including financial incentives for community health workers who identify patients with the disease. Accredited social health activists will be given 300 rupees (£3; €3.90; $4.90) for each patient identified with a rapid blood test. Patients treated in hospital will get 500 rupees a day as compensation for missed earnings.
A new drug
Crucially, India is finally ready to roll out liposomal amphotericin B (AmBisome), a safe and effective treatment that requires only one intravenous administration. The World Health Organization, through an agreement with the producers of AmBisome, Gilead Sciences, has committed to provide supplies to cover the predicted caseloads until the end of 2016, and subsequently …