Visceral leishmaniasis (VL) is arguably one of the deadliest neglected tropical diseases. People in poverty bear the largest burden of the disease. Today, the largest proportion of persons living with VL reside in the Eastern African countries of Ethiopia, Kenya, Somalia, South Sudan, and Sudan. These East African countries are among the top 10 countries reporting the highest number of cases and deaths. If left undiagnosed and untreated, VL almost always results in death. Subsequently, there is a need for integrated efforts across human, animal, and vector-control programs to address the scourge of VL in East Africa. In the East African region, the challenges including socio-cultural beliefs, poor health system, political instability, and limited epidemiological understanding impede the implementation of effective VL control strategies. The availability of funding, as well as diagnostics and treatment options, are also devastatingly limited. Furthermore, given the realities of climate change and population movement in the region, to effectively address the scourge of visceral leishmaniasis in East Africa, a regional approach is imperative. In this paper, we highlight some of the key challenges and opportunities to effectively move towards an effective control, and eventually elimination, of VL in East Africa. To do this, we underline the need for a fully integrated program in East Africa, inclusive of effective diagnostics and treatment, to effectively reduce and eliminate the burden of VL in the region, subsequently paving the way to achieve global elimination goals.

Globally, more than one billion people suffer from one or more neglected tropical diseases (NTDs). These diseases create enormous suffering, rob individuals of social and economic opportunities, and set-back countries’ development efforts. It is now clear that transmission and elimination of many NTDs is attainable in our lifetime. The elimination of NTDs will not happen without a concerted effort and plan to ensure that the most affected countries have a robust clinical, public health, laboratory, pharmaceutical, and research capacity to ensure that the last mile towards reaching elimination is not only reached, but sustained. This means increasing strategic investments to develop and strengthen the NTD health workforce, develop and integrate innovative diagnostic approaches, effective treatments, and responsive surveillance systems. Equally important is ensuring that people living with lifelong disabilities resulting from NTDs receive the care and support they need to live healthy, productive, and fulfilling lives. African-based national non-governmental organizations, the private sector, research institutions, and governments play a vital role as they work to attain ambitious NTD elimination and control goals put forward by the global health community. The recent elimination of onchocerciasis in Niger, trachoma in Burundi and Malawi as well as ongoing progress to eliminate lymphatic filiariasis in Kenya and other sub-Saharan Africa countries demonstrate the capacity of African leadership in NTD control and elimination efforts.