Having contributed to the eradication of polio in India, the Gates Foundation is now planning to work with the new Indian government to wipe out kala azar.
The foundation’s co-chairs, Melinda Gates and her husband, former Microsoft co-founder and CEO Bill Gates, are in India to meet the new government, including Prime Minister Narendra Modi and his Cabinet colleagues, Ms. Gates said in an exclusive interaction with The Hindu .
“With polio, there were a lot of people who were worried that we were bringing in money or that we were diverting government funds and all that was going to happen was another scheme — that we were going to get it eradicated and then melt away. But there was a very purposeful plan put in place, where those resources were trying to bring up the quality of primary healthcare centres,” Ms. Gates said. Those successes will propel the government’s push to eradicate kala azar by 2015, she added.
The second largest parasitic killer in the world after malaria, kala azar is concentrated in 52 districts in Bihar, Uttar Pradesh, Jharkhand and West Bengal. India officially reported fewer than 5,000 kala azar cases in 2011 and fewer than 100 deaths due to the disease, according to the World Health Organisation. However, the international health community believes these to be gross underestimation; while India reported just over 1,000 malaria deaths in 2011, medical journal Lancet placed the estimate 40 times higher.
Eradicating kala azar is possible, public health experts say. “Kala azar affects the most marginalised communities,” Manish Kakkar, senior public health specialist at the Public Health Foundation of India, told The Hindu . “It is highly concentrated geographically. In addition, it is only carried by humans and not animals in India. Both these factors make it something that can be eradicated,” Dr. Kakkar said.
The drug treatment for the disease was highly effective, but there was poor compliance, he said.
Simultaneously, the Gates Foundation has committed to spending $1.5 billion over the next five years on maternal and child health. “I don’t think it was lost on anybody that Prime Minister Modi’s speech on Independence Day really highlighted women in it,” Ms. Gates said.
The new administration is talking more about family planning than previous governments, and has good experience in succeeding, she said, referring to Health Minister Harsh Vardhan’s role in the polio eradication programme. The new government is also committed to setting up more schools of public health to produce cadres of trained health care workers, she said. The challenge of financing, however, remains, she said.