Developing a strategic plan for the elimination of visceral leishmaniasis in eastern Africa. Report of a stakeholder meeting, Nairobi, Kenya, 24–27 January 2023

11 June 2024

| Guidance (normative)

Developing a strategic plan for the elimination of visceral leishmaniasis in eastern Africa. Report of a stakeholder meeting, Nairobi, Kenya, 24–27 January 2023

Overview

The World Health Organization (WHO), in collaboration with the END Fund and the Drugs for Neglected Diseases Initiative (DNDi) and with the participation of the Special Programme for Research and Training in Tropical Diseases (TDR), convened a meeting of national programme managers, donors, partners and stakeholders in Nairobi, Kenya on 24–27 January 2023 to develop a strategic framework for the elimination of visceral leishmaniasis (VL) in eastern Africa. The four-day meeting was attended by more than 90 participants including representatives from the health ministries of Chad, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda.

The objectives of the meeting were: (i) to review the current epidemiological situation of VL in the world and in countries of the eastern Africa subregion; (ii) to finalize a high-level strategic framework for the elimination of VL as a public health problem 2023–2030, with subregional and country-level targets; (iii) to develop a framework on long-term financing mechanisms including sustained procurement and medical supplies (first-line treatment and diagnostic tests); and (iv) to develop a call for action (the Nairobi declaration) by the Member States and stakeholders. The meeting was conducted in technical sessions, a high-level round table, group work, plenaries and extensive discussions leading to conclusions and recommendations agreed by consensus for action.

Conclusions and recommendations

VL is a severe clinical disease in the eastern Africa subregion. The disease is outbreak-prone and fatal. In the past four decades, more than 100 000 case fatalities attributable to VL have occurred in this subregion, demonstrating the devastating impact of this chronic illness. Eight countries (Chad, Eritrea, Ethiopia, Kenya, South Sudan, Somalia, Sudan, and Uganda) share more than 60% of the global burden of the disease. More than 50% of new cases occur in children and young adults. The disease is associated with malnutrition, poverty, population displacement, migration, climate change and lack of economic resources.

Elimination of VL is linked with and will contribute to achieving several of the Sustainable Development Goals, namely Goal 1 (No poverty), Goal 2 (Zero hunger), Goal 3 (Good health and well-being), Goal 5 (Gender equality), Goal 8 (Decent work and economic growth), Goal 10 (Reduced inequalities) and Goal 13 (Climate action).

Successes and lessons learnt were presented from the VL elimination initiative of the WHO South-East Asia Region and from the kala-azar elimination programme in India. Since the launch of the initiative in 2005, the incidence of new cases has fallen by 97%, due to, among other factors, political commitment and the signing of a Memorandum of Understanding among endemic countries of the region.

The participants recommended unanimously to launch an initiative to eliminate VL as a public health problem in the eastern Africa subregion to reduce neglect, inequalities, and social and economic impacts.

A major outcome of the high-level round table discussions was an agreement to sign a Memorandum of Understanding among the eight countries to reflect political commitment.

National programme managers and stakeholders issued the Nairobi Declaration to highlight the key focus areas on the path of elimination.

WHO was requested to constitute an eastern African (WHO African and Eastern Mediterranean regions) technical advisory group to review progress and provide strategic directions for implementing the strategic framework in endemic countries.

WHO Team

Control of Neglected Tropical Diseases (NTD)

Editors

World Health Organization

Number of pages

Reference numbers

ISBN: 978-92-4-009557-1