The Indian government has announced that the country's scientists have developed a potential therapeutic strategy against visceral leishmaniasis or kala-azar, a neglected tropical disease (NTD). It is a complex infectious disease transmitted by the bite of female Phlebotomine sandflies. It affects millions of Indians annually, making it the second most common parasitic killer after malaria, according to the country's Ministry of Science and Technology.
Last month, the World Health Organisation (WHO) applauded the country for "redoubling efforts to resolve remaining challenges in the elimination of visceral leishmaniasis, also known as kala-azar, as a public health problem".
“India has a comprehensive elimination strategy and has made great strides to eliminate kala-azar as a public health problem among the estimated 130 million at-risk population in 54 districts of four states where the disease is endemic. Well-trained health workers and volunteers provide promotive, preventive, curative, and rehabilitative services which are backed by an effective case referral system,” said Dr Roderico H. Ofrin, the World Health Organisation (WHO) Representative for India.
According to the WHO, since 1992, after years of accelerated programme implementation, the number of kala-azar cases in India has dropped 97 percent. Fatalities fell from 1,419 in 1992 to 58 in 2018. In 2020, only 37 deaths were reported. Although this step is commendable, experts reveal that there is still a long way to go and the affected and vulnerable population remains large.
A study published earlier this year revealed that as COVID-19 exerted its greatest economic impact on India, it could derail otherwise promising control and elimination efforts against NTDs in the country, like soil-transmitted helminth infections and lymphatic filariasis.
Studies suggest that India has the highest number of major NTDs in the world, with at least 11. Moreover, these complex groups of diseases are not evenly distributed across the country; rather, they are more prominent in poverty-stricken urban and rural regions of the nation.
"The neglected tropical diseases are intricately interrelated with poverty and social-ecological systems. The diseases are so prevalent in India because of the lower socio-economic status of a large proportion of the population of the country, the presence of the environmental and climatic conditions apt for the propagation of the vectors for these infections and thus the increased prevalence of these infections," Dr. Monalisa Sahu, an infectious diseases consultant at Yashoda Hospitals in Hyderabad, told Sputnik.
Dr. Anjali Hooda Sangwan, MBBS, MD (Internal Medicine), USA told Sputnik that there is a need to roll out mass vaccination against such diseases, as many drugs are available for most of them.
"In India we need to perform the mass administration of vaccines and drugs for these conditions by setting up health check-up camps in overpopulated and low social-economic areas; educating the people about the symptoms of these diseases and timely treatment are also very important which can be done through media, newspapers, and local announcements," Dr. Sangwan said.
On Monday, the WHO released a new manual to guide health workers to safely administer donated medication for NTDs. Medicine for NTDs, mainly donated by pharmaceutical companies, are manufactured under stringent regulatory authority guidelines or are pre-qualified by the WHO. To ensure their safe administration, the WHO has already published formal and informal guidance, including on the management of serious adverse events.
Although these diseases affect many people, they generally receive less funding for research and treatment than illnesses like tuberculosis, HIV-AIDS, and malaria, according to the WHO.
A diverse group of communicable diseases, NTDs are common in tropical and subtropical conditions in 149 countries. The WHO states that these diseases affect more than one billion people and cost developing economies billions of dollars every year.
"All organs can be affected, a high suspicion index and knowledge about the different groups of tropical pathogens can help clinicians in the early recognition and timely diagnosis and appropriate management of these infections, based on knowledge of the respective geographical epidemiology. Clinical signs and patient presentations are often indistinctive. Linking MDA, vaccinations, integrated vector management, and improved surveillance together as part of overall efforts to strengthen health systems in the region can be helpful," Dr. Sahu told Sputnik.
In 2005, India officially eliminated leprosy, another NTD, reducing its prevalence rate to 0.72 per 10,000 people at the national level. However, WHO data suggests that around 58 percent of all newly diagnosed leprosy cases in 2018 were in India. To seek adequate awareness of the matter, the global health body declared 30 January "World Neglected Tropical Diseases (NTD) Day" in May of this year.