Crusade against kala-azar

Bhutan and Thailand have joined Bangladesh, India, and Nepal to fight kala-azar, a debilitating tropical disease that affects the poorest of the poor in the WHO’s Southeast Asia region.

Health ministers of these countries signed an MoU on Tuesday in Dhaka on the sidelines of the WHO regional meeting and vowed to eliminate the disease by 2020.

The eradication of kala-azar means reducing the number of cases to a level where it is no longer a public health problem.

The target is to cut the incidence to one per 10,000 people annually at the district or sub-district level.

Bangladesh, Bhutan, North Korea, India, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka, Thailand and Timor-Leste are the members of the WHO’s South-East Asia region.

The sand-fly-borne disease was mostly prevalent in Bangladesh, India and Nepal, which prompted these countries to sign a ten-year MoU in 2005.

But, recently, the disease emerged in Bhutan and Thailand, “sporadically”.

This MoU intends to facilitate joint effort for its elimination, said WHO regional director Poonam Khetrapal Singh before the signing.

“We have political will,” she said.

WHO Director-General Margret Chan, who was also present, congratulated the ministers for their collective resolve to eradicate kala-azar.

“I’ll chase after you so that you can make good progress,” she said, adding it was possible to eliminate the disease as had been demonstrated by many countries.

WHO says more than 147 million people in the South-East Asia Region are at risk of contracting this life-threatening disease, mainly in Bangladesh, India and Nepal, with recent, sporadic cases, being reported from Bhutan and Thailand as well.

It says the MoU was necessary as these countries share international border.

The collaboration will include mutually agreed mechanisms of resource mobilization, exchange of information, inter-sectoral collaboration, research, capacity building, and technical support.

Left untreated, kala-azar can be fatal.

The sand-fly breeds in moist soil, caves, cracks in mud walls and rodent burrows.

It disease is closely linked with malnutrition, poor housing, and illiteracy.

However, health minister Mohammad Nasim said Bangladesh is close to eliminating it.

“We achieved 90 percent success,” he said, adding that “collectively we’ll be able to fight off the disease from this region”.

India’s health minister Harsh Vardhan said they had started a “house-to-house” programme to eliminate kala-azar “as soon as possible”.