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PAHO Regional Program on Leishmaniasis: Fighting a Neglected Tropical Disease Affecting the Poorest of the Poor

Situation Brief, Americas

Definition: Leishmaniasis is set of parasitic vector-borne diseases transmitted by the sandfly. It is also one of the most neglected tropical diseases, with millions of people infected (mostly the poor) and millions of new cases each year, some of which interact with HIV. Many more are at risk.

The most common form, cutaneous leishmaniasis, causes permanent disfiguration. Another form, visceral leishmaniasis (VL), is almost always fatal. At the same time, there is a lack of information on the epidemiology of the diseases, which creates difficulties in planning prevention and control measures. The disease carries a heavy economic burden as well.

Distribution:The disease affects the tropical areas of the Americas. Brazil is one of the countries that make up 90% of all visceral and cutaneous leishmanisis cases on the global scale. The disease affects the most vulnerable populations. Though it generally occurs in remote areas (the jungle), urban transmission is on the increase, especially in shantytowns. Moreover, countries are often not required to report cases of this disease.

PAHO Regional Program on Parasitic & Neglected Diseases
Leishmaniasis: 2007 Update
WHO, Control of Neglected Tropical Diseases

Program Activities

1. Establish sentinel surveillance sites.
2. Find cheaper drugs.
3. Increase access to health services (i.e. health sector reform).
4. Generate epidemiological data for disease detection and treatment (for the national programs).
5. Build capacities for the above.
6. Decentralize structures in disease foci.
7. Advocate for cheaper drugs / search for new alternatives.
8. Carry out research on the above.
9. Draft guidelines.
10. Set up task forces in the countries.
11. Monitor and evaluate progress.

Challenges: Leishmaniasis continues to be a major public health problem and is a disease targeted for research by the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), with which the PAHO Communicable Disease Research Program interacts. In addition, PAHO's multidisease approach for neglected diseases also entails collaboration with the PAHO Regional Program on Parasitic and Neglected Diseases. Leishmaniasis requires better screening, diagnostics, and treatment, as well as a greater number of effective and less costly drugs. There is a need for more international participation. Malnutrition, poverty, and low socioeconomic status all play a role in this disease. At the same time, first-line treatment is costly and access to services is poor. Preventive measures such as bednets and vector control are economically feasible and can help reduce transmission. Many of these factors can be addressed via an integrated approach to disease management involving interprogrammatic cooperation and even "piggy-backing" grants.

PAHO Leishmaniasis Page
WHO Leishmaniasis Page
TDR Leishmanisis Page