Sustaining visceral leishmaniasis elimination in Bangladesh - Could a policy brief help?

PLoS Negl Trop Dis. 2017 Dec 12;11(12):e0006081. doi: 10.1371/journal.pntd.0006081. eCollection 2017 Dec.

Abstract

Bangladesh has made significant progress towards elimination of visceral leishmaniasis, and is on track to achieve its target of less than one case per 10,000 inhabitants in each subdistrict in 2017. As the incidence of disease falls, it is likely that the political capital and financial resources dedicated towards the elimination of visceral leishmaniasis may decrease, raising the prospect of disease resurgence. Policy memos may play a crucial role during the transition of the elimination plan from the 'attack' to the 'consolidation' and 'maintenance' phases, highlighting key stakeholders and areas where ongoing investment is crucial. An example of a policy brief is outlined in this paper. The background to the current elimination efforts is highlighted, with emphasis on remaining uncertainties including the impact of disease reservoirs and sustainable surveillance strategies. A stakeholder map is provided outlining the current and projected future activities of key bodies. Identification of key stakeholders subsequently frames the discussion of three key policy recommendations in the Bangladeshi context for the transition to the consolidation and maintenance phases of the elimination program. Recommendations include determining optimal vector control and surveillance strategies, shifting the emphasis towards horizontal integration of disease programs, and prioritising remaining research questions with a focus on operational and technical capacity. Achieving elimination is as much a political as a scientific question. Integrating the discussion of key stakeholders with policy priorities and the research agenda provides a novel insight into potential pathways forwards in the elimination of visceral leishmaniasis in Bangladesh and in the rest of the Indian subcontinent.

MeSH terms

  • Bangladesh / epidemiology
  • Capital Financing
  • Communicable Disease Control / organization & administration*
  • Disease Eradication / organization & administration*
  • Epidemiological Monitoring
  • Health Policy
  • Humans
  • Leishmaniasis, Visceral / epidemiology*
  • Leishmaniasis, Visceral / prevention & control*

Grants and funding

The paper arose out of work prepared during a Masters program. Funding information for the Masters program is provided below: The Rhodes Trust (http://www.rhodeshouse.ox.ac.uk/australia), Oxford University Graduate Studies and Ratiu Charitable Foundation (http://www.ratiufamilyfoundation.com), Mexican National Council of Science and Technology (http://www.conacyt.mx), Start-up Nation Public Service Fellowship (Mexico), Jardine-Oxford Graduate Scholarship (http://www.jardines.com/community/jardine-foundation.html), Ministry of Education and Higher Education, Supreme Education Council, Higher Education Institute, Hamad bin Khalifa Scholarship, Blavatnik School of Government (http://www.bsg.ox.ac.uk). The funders had no role in study design, data collection or analysis, decision to publish, or preparation of the manuscript.