Transmitted by the bite of a sand fly, kala azar is a vector-borne disease, endemic in 76 countries around the world. Typically, the disease thrives in impoverished areas and is almost always fatal if left untreated. Bihar is the state in India where kala azar is most endemic.
Supporting the roadmap for Kala azar elimination
On September 2, 2014, MSF welcomed the Government of India’s initiative to adopt Single dose liposomal amphotericin B (LAmB), as a first-line drug for treating kala azar (Visceral Leishmaniasis - VL) in Bihar, Jharkhand and West Bengal at both district hospital and block levels. The announcement made by the then Minister of Health and Family Welfare, Dr. Harsh Vardhan in Patna paved the way for providing safer and more effective treatment for kala azar and to achieve elimination by reducing the annual incidence to less than 1 case per 10,000 at the block level.
Neglected, no more?
It was on November 17, however, in Vaishali, Bihar, that single dose LAmB was formally implemented as a single dose treatment for kala azar in Bihar at the primary health centre level and district hospital levels, meaning that patients could now seek treatment within walking distance of their homes MSF extended its full support to the government of Bihar in implementing this new treatment protocol as the preferred first-line medicine to patients diagnosed with the disease.
Jomy Chacko, an MSF nurse demonstrates the practical preparation and administration of Single dose liposomal Amphotericin B during a training for doctors and nurses at the Sadar Hospital in Godda, Jharkhand. MSF medical teams have been supporting the NVBDCP and the central government’s rollout of the new treatment regimen for kala azar in the states of Bihar, Jharkhand and West Bengal. Photo credits: Dr.Prince Mathew/MSF
Single dose LAmB is also a more patient-friendly drug as a it requires only a single point of contact with the health system and can be administered to almost all categories of patients, including pregnant women and young children and can be administered at different healthcare levels (local health centres and hospitals). Till date MSF has treated, free of charge, more than 11,000 patients with LAmB and has achieved high cure rate results.
Understanding the impact
The treatment for Kala azar will now take a mere two hours compared to the previous treatment protocol that was administered over 28 days. This is bound to have a positive impact on reducing the mortality rates of this neglected disease, particularly on the poorest of the poor population who are typically vulnerable to the disease.
At the announcement, the State Programme Officer, Shri M.P. Sharma said “Although the roll out of single dose Ambisome will be done in phases; by next year this new treatment will be made available free of cost in all the 33 districts in Bihar.”
In addition, Dr. Prince Mathew, Deputy Country Director,MSF India, said, “MSF along with other partners like the Kalacore consortium is rapidly scaling up its training and implementation of Single Dose Lamb (Ambisome) across health facilities in Bihar, Jharkhand and West Bengal. Since the notification of the new treatment regimen, over 400 medical doctors and nurses across the three states have received training. By mid-2015, over 33 districts in Bihar, 4 in Jharkhand and 4 in West Bengal would have been trained and patients started on treatment.”
A number of donors in India have played their part in making this happen. MSF thanks its individual private donors, who have given hope to the betterment of the situation in Bihar with respect to Kala azar treatment and diagnosis.