The Kala-Azar Crisis in East Africa
A Deadly Parasitic Threat
Across Kenya, Sudan, and Ethiopia, frail and feverish patients are being taken to emergency clinics by their stressed families, blasted by a parasitic executioner. It may seem like malaria, yet these patients are indeed affected by a lesser-known parasitic illness, visceral leishmaniasis, also known as kala-azar.
The Global Impact
Kala-azar is the second deadliest parasitic killer in the world after malaria. The World Health Organization (WHO) estimates that 50,000 to 90,000 people globally are infected each year. Without treatment, it is almost always fatal.
Progress Under Threat
Many years of efforts by health ministries, specialists, and medical organizations have led to significant advances in controlling the disease. Better treatments have been developed, and the number of cases has been dramatically reduced in some parts of the world, particularly in South Asia.
In Kenya, there was significant progress in 2021, "the first in many years during which an annual outbreak of kala-azar did not occur," said Dr. Sultani Matendechero, head of the neglected tropical diseases division of the Ministry of Health in Kenya. However, to maintain this progress, access to diagnostic test kits and effective treatments must continue.
The Perfect Storm
This is now under threat. Kala-azar, already one of the most neglected diseases globally, is at risk of becoming even more neglected due to:
- Indirect effects of the Covid-19 pandemic
- Withdrawal by pharmaceutical companies
- Significant donor budget cuts
Treatment Shortages
First, kala-azar control progress is compromised by a severe shortage of a key "second-line" drug given to patients when the standard treatment fails. Known as AmBisome, this anti-parasitic treatment is used for vulnerable kala-azar patients such as pregnant women or severe cases.
Diagnostic Challenges
Another major concern is diagnostics. The American diagnostics company Bio-Rad announced that in 2022 it will stop producing the "IT-leish" rapid test. This is the only test with high enough sensitivity to detect kala-azar in Eastern Africa.
Call to Action
Thousands of lives are at risk. We need to act now. Donors and kala-azar endemic countries must step up. The industry must prioritize kala-azar treatment and diagnostic production. The outcome of another course of action will be nothing short of a humanitarian disaster.
