Visceral leishmaniasis (also known as kala-azar) is caused by infection with leishmania parasites through bites of infected sandflies that breed in and around homes or farms.

Number of cases reported Based on the best available data at the time of reporting (2015 and 2016 data)

Numbers of cases of VL reported

WHO roadmap target:

  • Regional elimination on the Indian subcontinent by 2020
  • Achieve 100% case detection and treatment

The VL programme has achieved a sustained decrease in the number of cases reported globally during the past 5 years, and the decrease in global case fatality rate has met the target through a strategy of case detection, treatment and vector control.

The Indian subcontinent is on track to achieve its elimination target, with incidence rates dropping steadily and an increasing number of districts declaring that the disease had been eliminated as a public health problem.

WHO, with endemic countries and partners, has significantly improved data management over the past 5 years, regularly collecting, analysing and disseminating data from the programmes in the 25 high-burden countries. More resources for data collection and management at national level would help reduce data reporting delays and gaps and further enhance surveillance and effective targeting of interventions.

The programme on the Indian subcontinent is supported by many stakeholders. Support is managed in countries in regular coordination meetings of national programme managers. Active screening, a vital programme activity, is supported by partners, although cases are under-reported. Thus, better data management at national level is required to make data available for monitoring, evaluation and planning and recognition of under-detection rates.

Research on vector control is important, especially as the vector is now showing resistance to insecticides.

New diagnostic tools would facilitate early diagnosis and reduce transmission. The treatment currently used on the Indian subcontinent is difficult to administer and ill-suited for use in remote health care facilities.

In addition, the treatment is not highly effective in African VL, and safer treatment that is easier to administer would accelerate achievement of the programme goals.

Improved and more effective surveillance will be critical to achieve and sustain elimination, given reducing case numbers.

All requests for AmBisome® were filled by Gilead and, in late 2016, the company signed a new 5-year agreement to donate drugs and to fund better tools for diagnosis and treatment.

This is part of Reaching a Billion, the fifth progress report of the London Declaration on NTDs. Read the full report.