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122 THIRD WHO REPORT ON NEGLECTED TROPICAL DISEASES *** Fig. 4.9.1 Distribution of visceral leishmaniasis, worldwide, 2012 Number of new VL cases reported, 2012 >1 000 100 1 000 5 000 1 000 4 999 No data available
*** THE DISEASES − CHAPTER 4 123 rates has been reported from Brazil and Ethiopia. In Brazil, the coinfection rate increased from around 2.5% (2005) to 6.6% (2011), and in northern Ethiopia from 19% (1998–1999) to 34% (2006–2007). The introduction and expanded implementation of antiretroviral treatment, however, has helped to reduce the incidence of visceral disease, delay relapses and increase survival of coinfected patients in many countries. Epidemics of cutaneous leishmaniasis in Afghanistan and the Syrian Arab Republic, where war and civil unrest prevail, have hampered control (7). Outbreaks in other major endemic countries, such as Algeria and Morocco, have been managed and the number of cases reduced significantly. Algeria reported over 30 000 cases in 2005 but only 6428 in 2013. Morocco reported 6700 cases of zoonotic cutaneous leishmaniasis in 2010 but only 537 in 2013. Progress towards Roadmap targets The World Health Assembly adopted resolution WHA60.13 on the control of leishmaniasis in May 2007, reinvigorating WHO’s mandate to lead the expansion of control programmes (Annex 1a). Following this major milestone, WHO convened an Expert Committee on the control of the leishmaniases that resulted in the publication of the technical report series in March 2010 (8). Since then, WHO has updated information on global epidemiology and access to medicines. The epidemiological update identified gaps in knowledge about the actual burden of the disease and its incidence in most endemic countries, and the need to develop robust surveillance systems. Mapping of the distribution of the disease has been updated and made available in the WHO Global Health Observatory; a new leishmaniases country profile is in progress. WHO has also published two manuals on the control of post kala-azar dermal leishmaniasis and a health workers’ atlas for distribution to the endemic countries. The Roadmap targets the elimination of visceral leishmaniasis as a public-health problem from the South-East Asia Region by 2020 and a significant reduction in its morbidity and mortality in other endemic regions. Following the agreement in 2011 between WHO and Gilead Sciences for the donation of 445 000 vials of liposomal amphotericin B to treat visceral leishmaniasis, the medicines were distributed to all the beneficiary countries in 2013. The UK Government through DFID is providing substantial financial support to WHO and other stakeholders to strengthen the fight against this disease. Particularly in the South-East Asia Region, the DFID fund provides an important opportunity to achieve the target set by the kalaazar elimination programme of reducing the incidence of the disease to less than 1 case per 10 000 population at subdistrict level. Such financial assistance has contributed significantly to reinvigorating the coordination and implementation capacity of the ministries of health of the beneficiary countries; strengthening the capacity of the health-care system in the most endemic areas to deliver better services; and improving case management, disease surveillance and vector control.
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INVESTING TO OVERCOME THE GLOBAL IM
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*** FOREWORD ix FOREWORD BY THE DIR
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*** EXECUTIVE SUMMARY xi EXECUTIVE
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*** EXECUTIVE SUMMARY xiii for the
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*** EXECUTIVE SUMMARY xv Neglected
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*** THE RESOLUTION AND THE ROADMAP
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*** INVESTING TOWARDS UNIVERSAL COV
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*** KEY INTERVENTIONS: SITUATION RE
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*** ANNEXES 179 ANNEXES
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*** ANNEXES 181 Annex 1a (cont’d)
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*** ANNEXES 183 WHA66.12 Recognizin
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*** ANNEXES 185 WHA66.12 3. REQUEST
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*** ANNEXES 187 Annex 3. Classifica
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*** ANNEXES 189 Annex 5. Medicines
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*** ANNEXES 191 WHO REGIONAL OFFICE
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