Content :

Leishmaniasis – The situation today

 

• What is leishmaniasis?
• Treatment
• Epidemiology
• Sanofi-aventis and leishmaniasis

What is leishmaniasis?

"Leishmaniasis is a parasitic disease transmitted by the bite of the sandfly. This extremely complex disease has six forms.

• Visceral leishmaniasis (VL) or kala azar, which attacks the internal organs, is the most severe form. Left untreated, it is usually fatal within two years.
• Furthermore, a percentage of cases can evolve to skin dissemination of parasites (post-kala azar dermal leishmaniasis).
• The cutaneous form  is the most common. It usually causes ulcers on the face, arms, and legs. Although the ulcers heal spontaneously, they cause serious disability and leave severe and permanently disfiguring scars. 
• Far more devastating is the mucocutaneous form, which invades the mucous membranes of the upper respiratory tract, causing gross mutilation as it destroys the soft tissues of the nose, mouth, and throat. 
• Diffuse cutaneous leishmaniasis produces chronic skin lesions that never heal spontaneously,
• and finally, recurrent cutaneous leishmaniasis is a relapsing form which appears after treatment."  

(Reference: brochure on the new cooperation between the WHO and sanofi-aventis 2006-2011)
 

Treatment

There is currently no vaccine or prophylactic medication available. The only individual preventive measures that are effective to date against the disease are: insecticide-impregnated mosquito nets and the use of insecticides such as DDT. Additionally, care must be taken to screen and monitor animal reservoirs (dogs and small forest rodents).

Treatment of the disease is based on pentavalent antimony (meglumine antimoniate and sodium stibogluconate), still today considered to be the first-line treatment, and on the second-line drugs, namely amphotericin B, liposomal amphotericine B, pentamidine isethionate, paromomycin and miltefosine.  

Epidemiology

Leishmaniasis is endemic in 88 countries on four continents: Africa, America (Central and South), Asia and Europe.
According to the WHO, some 350 million people are at risk of developing the disease. The Organization estimates that 12 million are currently afflicted, and that they live mainly in poor, isolated areas. Leishmaniasis affects about 1.5 to 2 million people every year. The disease causes thousands of deaths (70% of the victims are children) and leaves thousands more with severe disabilities.

Five hundred thousand people (about 25% of all new cases) contract the visceral form (fatal if left untreated) in 62 countries. Every year, more than 50,000 people die from VL. The vast majority (90%) of kala azar sufferers live chiefly in Bangladesh, Brazil, India, Nepal and Sudan. 
 

Sanofi-aventis and leishmaniasis

Sanofi-aventis markets meglumine antimoniate and pentamidine, which are considered by the WHO to be essential drugs in first-line and second-line treatments, respectively, for all forms of leishmaniasis.
Given the large number of people affected by the disease in certain countries and the high prices of these different treatments, the cost of controlling this scourge would weigh extremely heavily on the countries' health budgets.

This is one of the reasons why sanofi-aventis decided to take its commitment even further.  

• Download the sanofi-aventis Access to Medicines brochure (new window, PDF, 8.1 Mb)
• Go to the Neglected diseases' section on the WHO website
• Go to the Tropical diseases' section on the WHO website