Leishmaniasis in the World Health Organization Eastern Mediterranean Region

Leishmaniasis represents a major public health problem in the Eastern Mediterranean Region (EMR) of the World Health Organization (WHO). Cutaneous and visceral leishmaniasis are mainly seen in 14 of the 22 countries of the region. In several of these countries outbreaks have an apparent tendency to occur at around 10-year intervals. In 2008, some 100000 new cases of cutaneous leishmaniasis were reported. Foci of zoonotic cutaneous leishmaniasis, caused by Leishmania major, occur in Afghanistan, Egypt, Iran, Iraq, Jordan, Libya, Morocco, Palestine, Pakistan, Saudi Arabia, Sudan, Syria, Tunisia and Yemen. Anthroponotic cutaneous leishmaniasis, caused by L. tropica, occurs in Afghanistan, Iran, Iraq, Morocco, Pakistan, Saudi Arabia, Syria and Yemen. Anthroponotic visceral leishmaniasis, caused by L. donovani, occurs mainly in Sudan and Somalia. Zoonotic visceral leishmaniasis, caused by L. infantum, occurs in most countries of the region. In order to address the problem of leishmaniasis in the EMR, WHO is supporting ministries of health through a strategic plan focusing on (a) training programme managers and health workers on diagnosis and case management; (b) establishing a harmonized regional surveillance system; (c) creating a regional network of experts; (d) promoting political commitment of national governments.