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.In Kenya, the studies were carried out at Kacheliba Sub-County Hospital in West Pokot County in collaboration with the Ministry of Health.Health officials say the WHO decision paves the way for Kenya and other endemic countries to update their national treatment protocols.“Now that the WHO has updated its treatment guidelines, we are working to include the new treatments in our national guidelines so our patients can benefit from them as soon as possible,” said Wyckliff Omondi, Head of the Division of Vector-Borne and Neglected Tropical Diseases at the Ministry of Health.“Kenya has been an active partner in the development of these new treatments through the Leishmaniasis East Africa Platform, and we are hopeful that all our joint efforts will lead to the elimination of this terrible disease.”WHO noted that the new regimen also lowers the risk of developing PKDL, a skin condition that can emerge months after successful treatment of kala-azar.Although not usually fatal, PKDL causes visible skin lesions that often leave patients facing stigma, discrimination and psychological distress while also contributing to continued disease transmission.For women of childbearing age, WHO recommends pregnancy testing and appropriate contraception before treatment with miltefosine because of potential risks to fetal development. Those unable to use the medicine will continue receiving the existing standard treatment.Researchers described the revised guidelines as a significant step toward eliminating leishmaniasis, while noting that work is already underway to develop fully oral therapies that could eventually replace injectable drugs altogether. A promising oral candidate, LXE408, is currently being developed jointly by DNDi and Novartis.