By Duncan Mboyah
The World Health Organization (WHO) has endorsed a new leishmaniasis regimen with less side effects for the management of the disease in Eastern Africa.
The new regimen combines oral management with the injectable antibiotic paromomycin replacing long, toxic, injection-based treatments. It has been developed following clinical trials in Kenya, Uganda, Sudan and Ethiopia.
Dr. Daniel Ngamije Madandi, WHO director of Malaria and Neglected Tropical Diseases (NTDs) said that for too long, patients suffering from leishmaniasis have endured treatments nearly as punishing as the disease itself.
“These new WHO guidelines mark a turning point since the newly recommended combination treatment is over 90 percent effective, cuts injections from 34 to 14, and shortens hospitalization for post-kala-azar dermal leishmaniasis (PKDL) treatment from 60-90 days to 14,” Dr. Madandi said in a statement released in Kenya’s capital of Nairobi.
Dr. Madandi noted that by recommending safer, shorter, and more patient-friendly regimens, WHO is not just improving care but is accelerating the fight to eliminate the devastating disease and offering renewed hope to communities across eastern Africa.
“We are delighted that more patient-friendly treatments developed with our partners have been included in the WHO guidelines,” he added.
Dr. Fabiana Alves, Leishmaniasis-Mycetoma Cluster Director at the Drugs for Neglected Diseases initiative (DNDi) observed that the advances are important steps towards elimination.
Dr. Alves said partners are now working on the development of a promising new oral candidate that could help soon finally move away from injectable regimens.
According to Dr. Wyckliff Omondi, head, Division of Vector Borne and NTDs in Kenya, with the WHO update of its treatment guidelines, Kenya is also working to include the new treatments in the national guidelines to enable patients’ benefit from them as soon as possible.
“Kenya has been an active partner in the development of these new treatments through the Leishmaniasis East Africa Platform (LEAP), and we are hopeful that all our joint efforts will lead to the elimination of this terrible disease,” Dr. Omondi added.
The guidelines for Eastern Africa – VL and PKDL now bear the greatest burden of kala-azar, accounting for 79 percent of cases in 2024, with half of those affected being children under 15.
Kala-azar, also known as VL, is transmitted by the bite of an infected sandfly and is one of the world’s deadliest parasitic killers after malaria. It causes high fever, weight loss, anemia, spleen and liver enlargement, and kills if not treated in time.
The disease is endemic in 80 countries, with 50,000 to 90,000 new cases estimated to occur each year, while only 25–45 percent are reported to WHO.
PKDL is a skin condition that can develop months after successful kala-azar treatment, though not life threatening, it is highly stigmatizing, and many people living with PKDL face social isolation and mental health challenges. PKDL can also contribute to ongoing transmission of VL in affected communities.
The new treatments are expected to significantly improve the standard of care for patients with leishmaniasis, ahead of the expected arrival in the coming years of even more patient-friendly, innovative oral therapeutic options now in development.
These new therapies recommended for Eastern Africa were developed by the non-profit medical research organization Drugs for DNDi and partners.
