Visceral leishmaniasis control

Published on November 30, 2023   46 min

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I'm Koert Ritmeijer. I am the Neglected Tropical Disease Advisor at Médecins Sans Frontières based in Amsterdam. I have more than 25 years of experience in dealing with leishmaniasis. That is what the talk today will be about, visceral leishmaniasis and the control of the disease.
Leishmaniasis is a disease that is caused by vector-borne protozoan parasites, and is transmitted by infected female sandflies. It is endemic in 98 countries, with an estimated population at risk of 350 million, but it is very much underreported.
This is because leishmaniasis is a neglected tropical disease. The World Health Organization has a list of 20 neglected tropical diseases and some of them are fairly easy to treat or to control, for instance with Mass Drug Administration but leishmaniasis is among the more neglected tropical diseases because it is an intensified disease management NTD. This means that the disease is difficult to diagnose, difficult to treat, and difficult to control. It affects the poorest and most neglected populations. Neglect means that the disease is neglected by local governments because it is not prioritized as an important public health problem, therefore there's very little investment in control programs. It is neglected by institutional donors because they usually focus on the low hanging fruits where they can easily book successes in achieving control. That means that there's very little funding for control programs for diseases like leishmaniasis. Thirdly and also of importance is the neglect by pharmaceutical industries. Because the disease affects the poorest populations it is not a profitable market and therefore there is very little investment in research and development for better diagnostics, drugs and vaccines.