The World Health Organization (WHO) has released updated treatment guidelines for visceral leishmaniasis (kala-azar) and post-kala-azar dermal leishmaniasis (PKDL), introducing shorter, safer, and more effective treatment regimens for patients in eastern Africa and South-East Asia.
The new recommendations replace lengthy and more toxic treatment approaches with improved SSG-free regimens for eligible patients. In eastern Africa, WHO now recommends oral miltefosine combined with paromomycin for treating visceral leishmaniasis and PKDL, while South-East Asia will adopt shorter combination therapies using liposomal amphotericin B and miltefosine.
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“For too long, patients suffering from leishmaniasis have endured treatments nearly as punishing as the disease itself, especially in Africa. These new WHO guidelines mark a turning point,” said Dr Daniel Ngamije Madandi, WHO Director of Malaria and Neglected Tropical Diseases. “By recommending safer, shorter and more patient-friendly regimens, we are not just improving care; we are accelerating our fight to eliminate this devastating disease and offering renewed hope to communities across Africa and Asia.”
Kala-azar is one of the world’s deadliest parasitic diseases after malaria, affecting 50,000–90,000 people annually, although only 25–45% of cases are reported to WHO. PKDL, a skin condition that can develop after kala-azar, often causes stigma and social isolation despite not being life-threatening.
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“We are delighted that more patient-friendly treatments developed with our partners have been recognized in the WHO guidelines,” said Dr Fabiana Alves, Leishmaniasis-Mycetoma Cluster Director at DNDi. “These advances are important steps towards elimination, but we are already looking ahead. We are now working with Novartis on the development of LXE408, a promising new oral candidate that could help us soon finally move away from injectable regimens.”
“Now that the WHO has updated its treatment guidelines, we are working also to include the new treatments in our national guidelines, so our patients can benefit from them as soon as possible,” said Wyckliff Omondi, Head, Division of Vector Borne & Neglected Tropical Diseases at Ministry of Health, Kenya. “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.”
