Sudan has one of the highest rates of kala azar (or visceral leishmaniasis) in East Africa, a deadly tropical disease transmitted by sandflies. The region around Gedaref, 500 kilometres east of the capital, Khartoum, close to the border of Ethiopia is hardest hit by kala azar. The climate and topography are particularly favourable for the tiny insects that transmit the disease. They take refuge in the cracks that form in the ground after the rainy season, or in tree trunks, and in the dried mud walls of the houses. In Sudan, as elsewhere, the neglected tropical disease hits the poorest and most marginalised.

Kala azar especially affects people that have been weakened by malnutrition or that are already suffering from other diseases that weaken the immune system, such as HIV or TB. It is fatal if left untreated. The parasite infects organs such as the liver, spleen, and bone marrow, and depletes the immune system, leaving those infected vulnerable to other serious infections. Complicated to treat, most people require two daily painful injections over the course of 17 days. 



MSF has extensive experience of diagnosing and treating kala azar (visceral leishmaniasis). The 3 available drugs cause some side effects. They need to be used with caution after specific training. There is still a long way to go to control and eliminate this deadly disease in Sudan. Patients represent an unattractive market for drug companies. They see no profit to put research and development efforts into combatting kala azar.

It affects hundreds of thousands every year, mainly in Africa and Asia. MSF started its support to the kala azar treatment centre in Tabarak Allah during a major outbreak in 2010. Since then we treated almost 7,000 patients. This might not seem like a large number, but each patient treated is one life saved, given its high mortality rate.

MSF provided free diagnosis and treatment in Tabarak Allah hospital, created a kala azar training centre to train medical personnel from Gedaref and from MoH kala azar centres in other parts of the country, and signed a partnership with the Kala azar Research Centre (KRC) of the University of Gedaref. We hand over the project to the State Ministry of health on 31 May 2020.

COVID-19 can be especially severe in kala azar patients because of their immune deficiency and patients should be particularly protected and tested early.