Evidence-based vector-borne disease management and elimination of visceral leishmaniasis in Nepal

Nepal is endemic for several vector-borne diseases, such as malaria, dengue, and visceral leishmaniasis. Vector-bornediseases (VBD) are diseases caused by a pathogen that is transmitted to humans through the bite of an infected blood-feeding insect (so-called ‘vectors’), such as mosquitoes or sand flies. In recent years, several of these diseases havespread from the lowlands to the mountainous (Himalayan) regions in Nepal, most likely due to climatic changes whichfacilitate the survival of the vectors at higher altitudes. The current public health system, however, is not equipped for this,with surveillance systems not covering newly endemic areas, and resources for disease control measures mostly lacking.This is specifically also a challenge for visceral leishmaniasis, which is on the verge of being eliminated in Nepal but is nowprogressively advancing into new areas. We will strengthen capacity in Nepal to collect baseline information on the geographical spread of vectors and pathogensin different ecological settings. This will allow the development of risk maps and predictions for vector-borne diseases inNepal, both under current and future climate scenarios. In addition, we will address some of the most importantknowledge gaps currently hampering successful and sustainable elimination of visceral leishmaniasis in the country. We will facilitate translation of these newly gathered insights into updated and context-specific policies, by piloting newsurveillance strategies, formulating mitigation measures, and strengthening collaboration between the academic and the policy level. In addition, we will enhance capacity of policy makers to analyse routinely collected data, in order tomaximize the impact of the policy changes expected through this programme.

Nepal is endemic for several vector-borne diseases, such as malaria, dengue, and visceral leishmaniasis. Vector-bornediseases (VBD) are diseases caused by a pathogen that is transmitted to humans through the bite of an infected blood-feeding insect (so-called ‘vectors’), such as mosquitoes or sand flies. In recent years, several of these diseases havespread from the lowlands to the mountainous (Himalayan) regions in Nepal, most likely due to climatic changes whichfacilitate the survival of the vectors at higher altitudes. The current public health system, however, is not equipped for this,with surveillance systems not covering newly endemic areas, and resources for disease control measures mostly lacking.This is specifically also a challenge for visceral leishmaniasis, which is on the verge of being eliminated in Nepal but is nowprogressively advancing into new areas. We will strengthen capacity in Nepal to collect baseline information on the geographical spread of vectors and pathogensin different ecological settings. This will allow the development of risk maps and predictions for vector-borne diseases inNepal, both under current and future climate scenarios. In addition, we will address some of the most importantknowledge gaps currently hampering successful and sustainable elimination of visceral leishmaniasis in the country. We will facilitate translation of these newly gathered insights into updated and context-specific policies, by piloting newsurveillance strategies, formulating mitigation measures, and strengthening collaboration between the academic and the policy level. In addition, we will enhance capacity of policy makers to analyse routinely collected data, in order tomaximize the impact of the policy changes expected through this programme.