World Health Organization has released a major revision of its clinical guidance for treating visceral leishmaniasis (commonly known as kala-azar) and post-kala-azar dermal leishmaniasis (PKDL), aiming to ease the burden of two neglected tropical diseases affecting communities across eastern Africa and South-East Asia.
Kala-azar, spread through sandfly bites, ranks among the deadliest parasitic infections worldwide, second only to malaria. It triggers persistent fever, wasting, anemia, and organ enlargement, and is fatal without treatment. Roughly 50,000–90,000 new cases arise annually across some 80 endemic nations, though official reporting captures fewer than half of these. PKDL, a stigmatizing skin condition that can follow recovery from kala-azar, poses less physical danger but often leaves patients socially isolated.
The revised protocols shift eastern Africa away from decades-old reliance on painful, injection-heavy regimens using sodium stibogluconate, introducing an oral drug—miltefosine—paired with paromomycin injections that cut treatment duration and toxicity. South-East Asian patients with PKDL will now have access to shorter courses combining or substituting liposomal amphotericin B infusions with oral therapy. Guidance for managing disease relapse in the region has also been sharpened.
WHO officials described the update as long overdue relief for patients who’ve endured grueling treatment regimens, with roughly half of primary kala-azar cases and nearly all PKDL patients expected to benefit. Many of the newly endorsed therapies emerged from research by the Drugs for Neglected Diseases initiative and its partners, who indicated continued work on next-generation oral candidates to eventually eliminate injectable treatment altogether.
National health authorities, including Kenya’s Ministry of Health, have signaled plans to fold these recommendations into domestic treatment protocols in the near term.
Written By: Sayan Das
