Nepal signed a Memorandum of Understanding to eliminate Visceral Leishmaniasis (VL) as a public health problem (target yearly incidence of <1/10,000 population on district level) in 2005, and reached this elimination target in 2013.
After Nepal achieved the VL elimination target (by 2013), KalaCORE started working through B.P. Koirala Institute of Health Sciences, Dharan, and Institute of Tropical Medicine, Antwerp, Belgium as implementing partners in Nepal to develop capacity to sustain Visceral leishmaniasis (VL) (or Kala-azar) in endemic districts since May 2016. KalaCORE has worked to develop capacity to sustain visceral leishmaniasis (VL) elimination through early diagnosis, effective treatment, vector control and effective disease surveillance, targeting all endemic districts in the Eastern and Central regions of the country, including Kala-azar non-program districts of Nepal. In 2017, however, the target of elimination was breached, due to the report of Kala-azar cases in one of the hilly district called Dolpa, where six VL cases were reported out of a total population of 40,000 people. Dolpa district is one of the non-programme districts.
VL or kala-azar is a significant public health problem in Nepal. The programme initially identified 12 districts of central and eastern Terai region as KA endemic. However, six new districts were added to that list in 2016, including hilly districts form Western, Mid Western and Far Western Nepal, because sporadic cases have been consistently reported and local transmission was verified by epidemiological and entomological studies. Cases have been reported from other 32 districts but disease transmission needs to be verified. Despite this geographical expansion of the disease, the programme has seen a steady decline in incident cases and mortality since 2003.
In recent years, non-programmatic /non-endemic areas also reported VL cases. KalaCORE has been supporting the Government of Nepal for the strengthening the capacities of healthcare providers in all levels to respond to VL, by supporting a total of 31 health facilities across the country to report VL in a timely manner. Though the number of VL cases has been consistently low since 2014, validation of VL elimination as a public health issue in Nepal is now expected to be achieved in 2021.