Kala-Azar Policy and Programmes in Nepal: An Assessment

Background: Kala-azar (KA; visceral leishmanasis) is a debilitating and devastating disease, which targets the poor. KA first emerged in Nepal in 1980 and Government of Nepal (GON) has acknowledged the disastrous effects of the disease on domestic economic growth and community development through the explicit identification of KA as a health problem. Objective: The paper has twofold objectives: to describe the policies and plans with regard to KA in Nepal and to assess their overall effectiveness. Methods: The assessment is primarily based on secondary information. The data were collected from various policies and plans, reports, records in government offices, and published and unpublished documents among others. Data collected from various sources were triangulated and analyzed to produce mid-term assessment of elimination KA. Assessment and conclusions: The existing KA policies and plans of the GON have rightly targeted the major areas of intervention of KA treatment, prevention and control – such as surveillance and early detection, provision of free drugs for KA treatment, demand side financing, insecticide sprays, health education and information among others. Outcomes of the intervention are improving, but in slow rate. Coordination among the KA affected countries is found rather weak. The existing policy is not sufficient to reduce the imported KA cases.