Better access to treatment for Ethiopian kala azar patients

A kala-azar patient receiving a painful, intramuscular injection in the MSF-clinic in Humera, Ethiopia. Patients are cured for life after receiving an injection per day for 30 days. Medécins Sans Frontières has been advocating for the guideline for over three years, and contributed to its development through active participation in the national taskforce and the technical working group.

Patients in Ethiopia suffering from the deadly tropical disease kala-azar will get better access to medical care. The Ethiopian authorities have approved a national treatment guideline, a significant step in tackling this forgotten disease. The Federal Ministry of Health outlined its intention to establish six treatment centres within the next six months and to undertake training across the country.

Kala-azar (also known as visceral leishmaniasis) had been a neglected disease in Ethiopia with minimal treatment programmes available. Up until now the bulk of the kala-azar patients were dependent on Medécins Sans Frontières (MSF) or research institutions for medical care. MSF has treated more than 9,300 patients since the start of its kala-azar programmes in 1997.

Kala-azar is prevalent throughout the lowlands in the northeast of the country. "As the number of people who migrate to these areas is growing, the incidence of visceral leishmaniasis is expected to increase significantly," says Penny O'Connor, MSF medical coordinator in Ethiopia.

"Agricultural workers and participants in the national resettlement scheme, who originate from other areas, run a higher risk of contracting the disease because they usually lack immunity. But now patients will have a better chance at finding the right care because of the new guideline."

Besides Ethiopia, kala-azar is endemic in parts of sub-Saharan Africa, Southeast Asia and Brazil. The disease is caused by a parasite that is transferred by bites of infected small sandflies. It affects the immune system, causing fever, anaemia, a large spleen, weakness and wasting. Once symptoms occur, the disease is almost always fatal. But for those who can find treatment, the survival rate is over 90 per cent, and patients are cured for life.

The first ever national treatment guideline for kala-azar was approved at a 'consensus building workshop' organised by the Ethiopian Federal Ministry of Health in Adis Abeba. Medécins Sans Frontières has been advocating for the guideline for over three years, and contributed to its development through active participation in the national taskforce and the technical working group.