WHO approves new kala-azar treatment as Kenya prepares to adopt shorter, safer regimen

NAIROBI, Kenya, July 29 – The World Health Organization (WHO) has approved new treatment guidelines for visceral leishmaniasis (kala-azar) and post-kala-azar dermal leishmaniasis (PKDL) in a move expected to transform care for thousands of patients across Eastern Africa, including Kenya. The revised guidelines, announced on Wednesday, mark the first major update to WHO’s recommendations for the deadly parasitic disease in nearly two decades. They introduce, for the first time in Eastern Africa, an oral drug as part of the standard treatment, significantly reducing the number of painful injections patients must endure.

Under the new recommendations, patients with kala-azar will receive a combination of oral miltefosine and once-daily paromomycin injections for 14 days. The regimen cuts injections from 34 over 17 days to just 14, while patients with PKDL will also receive the same combination, reducing treatment from the current 60–90 days of injections to a 14-day hospital stay followed by oral medication at home. WHO said the updated regimens eliminate the use of sodium stibogluconate (SSG), a drug long associated with painful injections and severe side effects.

“For too long, patients suffering from leishmaniasis have endured treatments nearly as punishing as the disease itself,” 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, transmitted through the bite of infected sandflies, is among the world’s deadliest parasitic diseases after malaria and is fatal in up to 95 per cent of untreated cases. The disease causes prolonged fever, severe weight loss, anaemia and enlargement of the spleen and liver.

According to WHO, Eastern Africa accounted for 79 per cent of global kala-azar cases in 2024, with half of all patients being children under the age of 15. In Kenya, the disease is endemic in 11 counties, mainly in arid and semi-arid regions. The new treatment recommendations are backed by evidence from clinical trials conducted in Kenya, Ethiopia, Uganda and Sudan under the leadership of the Drugs for Neglected Diseases initiative (DNDi) and its partners.