Adapting lessons from the Indian subcontinent to accelerate elimination of visceral leishmaniasis as a public health problem in East Africa

Abstract

This viewpoint draws lessons from the elimination of visceral leishmaniasis (VL) as a public health problem in the Southeast Asia region (SEAR) to inform efforts in East Africa (EA), now the global epicenter of Leishmania donovani transmission. VL is fatal and there is no licensed vaccine. Success in India relied on robust surveillance, rapid diagnosis, single-dose treatment, vector control, and multi-partner coordination. EA faces additional challenges than SEAR with multiple sand fly vectors, sensitive diagnostics and longer treatment regimens, high population mobility, and gaps in ecological and epidemiological knowledge. We highlight how strategies from South Asia could be adapted while acknowledging EA’s unique ecological and health system complexities. These insights aim to guide sustainable VL control towards elimination of VL as a public health concern in the region.