India achieves target to eliminate visceral leishmaniasis 'Kala-Azar'

India has achieved its target to eliminate visceral leishmaniasis, commonly known as kala-azar, according to data from the National Centre for Vector Borne Diseases Control (NCVBDC). India had initially aimed to eliminate kala-azar by 2010, but the target was extended until 2023 due to persistent challenges.

Kala-azar, a vector-borne disease caused by protozoan parasites transmitted through sandfly bites, has posed a significant health challenge for decades, particularly in states like Bihar, Jharkhand, West Bengal, and Uttar Pradesh.

The latest data from NCVBDC indicates that India reported only 520 cases of kala-azar in 2023 across India, meeting the elimination criteria set by the World Health Organization (WHO), which defines elimination as no block in the country reporting more than one case per 10,000 people.

As per the WHO, in 2020, India accounted for 18 per cent of the global burden of kala-azar. The elimination has come after government interventions, including indoor spraying to kill sandflies, sealing potential breeding sites, and mobilising healthcare workers to ensure proper treatment completion.

Speaking on this, K Madan Gopal, Advisor, Public Health Administration, NHSRC-MoHFW, and former Senior Health Consultant at NITI Aayog, stated “For Kala Azar to end, key government interventions, including rigorous indoor residual spraying efforts aimed at curtailing sandfly breeding sites; the application of a special soil to seal crevices in mud walls, preventing sandflies from nesting; and the mobilisation of the ASHA network to ensure completion of treatment for Post Kala-azar dermal leishmaniasis (PKDL) patients, who require a 12-week course of Miltefosine, have been helpful in meeting our elimination targets (elimination for Kala Azar is defined as no block in the country reporting more than one case per 10,000 people).”

In addition to kala-azar, the data also reveals the HIV-VL coinfection and post-kala-azar dermal leishmaniasis (PKDL) cases in India. While progress has been made, challenges persist, particularly in states like Bihar and Jharkhand, where cases of PKDL remain relatively high.

Public health experts emphasise the importance of continued surveillance, robust healthcare infrastructure, and community engagement to prevent the resurgence of kala-azar and other vector-borne diseases. Speaking on the same, Gopal further added, “While we have achieved the required target numbers in terms of cases, sustaining this progress is crucial for India to be declared Kala Azar-free, which will eventually be done by the WHO post assessment of the overall situation in the country.”

Efforts to strengthen healthcare systems and improve access to diagnosis and treatment will be crucial in maintaining India's progress towards eliminating kala-azar and improving overall public health outcomes.