India has missed the 2017 deadline that Finance Minister Arun Jaitley had announced for elimination of Kala Azar (black fever) in his Budget speech last year. In fact, endemic blocks have increased from 61 to 68 in 17 districts of Bihar and Jharkhand.
The matter was taken up at a meeting of the health ministry last month. Officials told health secretary Preeti Sudan that a request to the Ministry of Rural Development for expediting construction of concrete houses, pending since 2001-02, was the primary reason behind the failure to control the disease.
Elimination is defined as reducing the annual incidence of Kala Azar (KA) to less than 1 case per 10,000 people at the sub-district level.
Further, a little-known skin condition called Post Kala Azar Dermal Leishmaniasis (PKDL) — a red flag for transmission of KA — has been growing steadily over the past few years.
KA is a slow progressing indigenous disease caused by a single-celled parasite of the Leishmania family.
The Empowered Programme Committee (EPC) of the National Health Mission discussed the issue in its December 22 meeting.
Dr P K Sen of the National Vector Borne Disease Control Programme (NVBDCP) told the committee that active case findings rather than an actual increase in the disease is the reason why the number of endemic blocks have increased.
Replying to Sudan’s query about why the target could not be achieved, an NVBDCP official told her that the list of KA endemic blocks had been shared with the rural development ministry with a request to construct concrete houses in these blocks in 2001-02. A reminder request was also sent recently to the rural development ministry.
“Dr Jagdish Prasad, DG, DGHS, further added that the KA vector needs to be eliminated to eliminate Kala Azar. As the endemic blocks have majority of houses made from wood, it is very difficult to eliminate the vector as it dwells in the wooden structure and escapes various measures to kill it. Hence, to stop the infection transmission, pucca houses need to be built. Secondly even after treatment of Kala Azar patients, it is the PKDL cases which become a source for future KA cases,” read the minutes of the meeting.
The meeting resolved to take up the issue of building concrete houses in KA endemic blocks with the rural development ministry on priority, and recommended that one-time incentive for PKDL patients should be doubled from Rs 2,000 to Rs 4,000.