Regional Strategic Framework for accelerating and sustaining elimination of kala-azar in the South-East Asia Region 2022-2026

Overview

Devastating epidemics of visceral leishmaniasis, also known as kala-azar, have been recorded in the Indian subcontinent, namely Bangladesh, India and Nepal, since the early 19th century. Sporadic cases have also been reported in Bhutan, Sri Lanka and Thailand. In 2005, the WHO South-East Asia Region accounted for 70% of the global disease burden.

In 2005, high-level political commitment from the Member States of Bangladesh, India and Nepal helped launch the Regional Kala-azar Elimination Initiative. It led to intensification of efforts in the national programmes, along with particular emphasis to strengthen regional partnerships among Member States, WHO, development partners and donor agencies. This also helped to facilitate rapid translation of research findings into policy and practice, coupled with remarkable advances in R&D for better treatment and diagnostics and interruption of transmission.

The outcome is reflected in the steady decline in the disease incidence: reported new cases of kala-azar in the Region have reduced by 95% in the last seven years and the South-East Asia Region now accounts for less than 20% of the global disease burden. About 98% of implementation units in the Region have achieved the target for elimination as a public health problem. This exemplifies the importance of political will and partnership to advance our NTD goals.

With this unprecedented achievement, the South-East Asia Region is moving into a new phase. Given the current gaps in available tools to achieve and verify interruption of transmission of kala-azar, continued efforts and vigilance will be required to sustain the gains and maintain the validation of elimination as a public health problem once achieved. The programmes will need to evolve and realign strategies towards the post-validation phase through innovation and integration for sustainability and multisectoral engagement. Investments for innovation over new tools and strengthening of primary health care need to continue.

This Regional Strategic Framework is intended to guide Member States, WHO, donors and partners on the strategic priorities to optimize, integrate and sustain kala-azar and PKDL surveillance, and complete case management and integrated vector management without losing focus for kala-azar elimination. The South-East Asia Region has a unique opportunity to demonstrate further success in the elimination of kala-azar and beyond, and fundamentally change the global NTD landscape. Commitment to eliminating the scourge of kala-azar from this Region must be reiterated and renewed. I urge all policy-makers, managers, research and implementation partners and donor agencies to work together to accelerate and sustain kala-azar elimination through implementation of this Regional Strategic Framework.

Let us together illustrate this model to successfully integrate and sustain essentialpublic health interventions and service delivery within the primary health care and health system to achieve and sustain kala-azar elimination as a public health problem in the South-East Asia Region.