If you read this newspaper, chances are you’ve never heard of kala azar even though it is the second largest parasitic killer in the world after malaria. And, if you know kala azar, you’ve probably never read a newspaper.

Kala azar is found in 88 countries, but 90 per cent of the cases are in India, Bangladesh, Nepal, Sudan and Brazil. According to the WHO, 350 million people are at risk of kala azar globally, with 200 million in India, Bangladesh and Nepal. Yet, even with about one-fifth of India’s population at risk, it’s still definitely a ‘most neglected disease’.

Medicins Sans Frontieres, winner of the Nobel Peace Prize in 1999, defines neglected diseases as those where most patients are very poor, live in remote or unstable areas, have limited access to healthcare and have limited or no political influence. It is tragic that diseases are neglected not because they are rare, but because their patients are at the bottom of the socio-economic heap. This is certainly true of victims of kala azar in the districts of Bihar, Jharkhand, UP and West Bengal where kala azar is endemic.

Also known as visceral leishmaniasis, kala azar presents itself as a persistent fever, lowers immunity, and causes anaemia and liver and spleen enlargement. It kills if not treated. It is transmitted when a female sandfly bites and picks up the parasite from an infected person and then transmits the parasite by biting another person.

In 2002, the government of India declared that it would eradicate kala azar by 2010. Despite the stated resolve, high-level political commitment, infrastructure, manpower and funding to implement the elimination programme, we have seen a rise in the number of cases since 2002.

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