Kala-azar Elimination

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  Kala-azar Elimination

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• Kala-azar elimination: Bihar to Miss DeadlineThe new cases of Kala-azar or Visceral Leishmaniasis have been reported in Bihar’s Muzaffarpur district, casting serious doubt on the state government’s efforts to eradicate the disease in the state by 2022. Bihar has already missed the Kala-azar elimination target four times since 2010. The first deadline was 2010, under the National Health Programme, followed by 2015. It was later extended to 2017 and 2020 due to the government’s failure to eliminate Kala-azar.
• Points to note: 

1. Kala-azar or Leishmaniasis - Visceral leishmaniasis, also known as kala-azar, is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver, and anaemia. If the disease is not treated, the fatality rate in developing countries can be as high as 100% within 2 years. It is a Neglected Tropical Disease (NTD) affecting almost 100 countries including India.
2. NTDs are a diverse group of communicable diseases that prevail in tropical and subtropical conditions in 149 countries. It is caused by a parasite called Leishmania, which is transmitted through the bite of sand flies.
3. There are three types of leishmaniasis - Visceral leishmaniasis, which affects multiple organs, is the most serious form of the disease. Cutaneous leishmaniasis, which causes skin sores, is the most common form. Mucocutaneous leishmaniasis causes skin and mucosal lesions.
4. Visceral leishmaniasis, which is commonly known as Kala-azar in India, is fatal in over 95% of the cases, if left untreated. 

• Reasons for missing the deadline: Elimination programmes lack direction and Kala-azar returns year after year. It was mostly the poor belonging to the Dalits, Other Backward Communities and Muslims, who were the main victims of the disease. There also has been a trend of decline in the number of Kala-azar cases in Bihar in the last few years. There were 23,084 cases in 2010, and by 2020, there were 2,712 cases, according to official data.
• National Kala-azar Elimination Programme: The National Health Policy-2002 set the goal of Kala-azar elimination in India by the year 2010 which was revised to 2015. Continuing focused activities with high political commitment, India signed a Tripartite Memorandum of Understanding (MoU) with Bangladesh and Nepal to achieve Kala-azar elimination from the South-East Asia Region (SEAR). Elimination is defined as reducing the annual incidence of Kala-azar to less than 1 case per 10,000 population at the sub-district level in India.
• NVBDCP: Presently all programmatic activities are being implemented through the National Vector Borne Disease Control Programme (NVBDCP) which is an umbrella programme for prevention & control of vector borne diseases and is subsumed under National Health Mission (NHM).
• National Vector Borne Disease Control Programme: The NVBDCP is the central nodal agency for prevention and control of six vector borne diseases i.e. Malaria, Dengue, Lymphatic Filariasis, Kala-azar, Japanese Encephalitis and Chikungunya in India. It works under the Ministry of Health and Family Welfare.

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