Kala Azar cases under control for two years: India gears to apply for elimination certificate 

India on track to eliminate Kala Azar as a public health problem with low case numbers and WHO certification in sight.

India could be at the threshold of eliminating Kala Azar as a public health problem with the country having managed to keep the number of cases under one in 10,000 as per the World Health Organization (WHO) parameters for elimination certification for two consecutive years now.

Kala Azar is the second deadliest parasitic disease after malaria in India. As per figures released by the Health Ministry India registered 595 cases and four deaths in 2023 and this year it has recorded 339 cases and one death so far.

If it can maintain the figures for another year India will become eligible to seek the elimination certificate from WHO making it the second country in the world after Bangladesh which in October became the only country to have eliminated Kala Azar, also known as visceral leishmaniasis, as a public health problem. The WHO validated this status after Bangladesh reported fewer than one case per 10,000 people in each of its subdistricts for three consecutive years.

Kala Azar is a disease caused by a protozoa parasite that is transmitted by the bite of an infected female sandfly. Symptoms include - irregular fevers, weight loss, enlarged spleen and liver, and anaemia. Kala Azar is fatal if left untreated in more than 95% of cases.

India’s National Health Policy (2002) initially set a target of eliminating Kala Azar by 2010, but this was later revised to 2015, 2017, and then 2020. The WHO’s Neglected Tropical Disease roadmap set a goal of eliminating Kala Azar by 2020, but the target was not achieved. The WHO is now accelerating work to achieve the target by 2030.

A disease is certified as eliminated as a public health issue when a country can prove that local transmission has been interrupted for a set period, and that there is a system to prevent the disease from re-emerging. WHO assesses countries’ submissions to determine if they meet the criteria for elimination.

K. Madan Gopal, advisor at the public health administration, National Health Systems Resource Centre, Health Ministry, said India’s Kala Azar programme focuses on active case detection, effective vector control, and raising community awareness. Achieving a low case of Kala Azar to less than one case per 10,000 population at the sub-district (block PHCs) for two straight years puts India on track to earn WHO certification for eliminating Kala Azar as a public health problem. This would mark a significant milestone.