Deadly, Under-Researched Fever Takes Toll On Africa

Kala azar - a Hindi word meaning Black Death - is a disease that continues to take its toll on African nations, according to a news bulletin out of Nairobi.

The sickness starts with the bite of a tiny sand fly and mutates quickly from there. The result is scary. The chills, then fever, followed by an onslaught of black lesions that will most likely prove fatal within six months unless there is treatment -- which for most, there may not be.

The impact of Black Death is frightening, far greater in scope than most people realize. It has killed more people than the 21-year civil war in Sudan, many of them extremely poor children.

"The people who are affected by the problem are poor. That's why we call it a neglected problem. Since you're dealing with a poor population, they won't be able to purchase the drug," said Dr. Willy Tonui of Kenya Medical Research Institute (KEMRI).

The disease has become a high priority of drug researchers worldwide. With the United Nations' 192-member World Health Assembly convening  Monday in Geneva, the governments of Kenya and Brazil issued a resolution urging the panel to take action. The resolution urges governments to set higher drug research priorities based on the disease's burden.

According to the UN, less than 10 percent of investment in health research went to diseases that affected 90 percent of the world.

"Developing countries have the capacity to provide new solutions for old diseases, but every day we see how difficult it is to get support  for research and development into diseases that affect the poor and  for which there is no profitable market," Dr. Davy Koech, KEMRI's CEO, said.

Also called visceral leishmaniasis, the disease causes extreme high fever, swelling of the spleen and massive weight loss. The illness is most common in the Sudan, according to the World Health Organisation. About 500,000 new cases appear every year in the world, and a sharp increase has been noted in the last decade. Bangladesh, India, Nepal and Brazil are other particularly dangerous countries.

Unlike treatments for epidemics such as AIDS and heart disease, there have been precious few advances in kala azar research and/or drugs in nearly two decades. Critics say that the problem is financial -- with little incentive to develop drugs for people who would never be able to pay for them, the major drug manufacturers have focused their attention elsewhere.

According to Medicins Sans Frontieres, or Doctors Without Borders, the disease has killed a third of the people in Sudan's Western Upper Nile region from 1990-1994. That amounts to 100,000 of 300,000 humans. The organization calls it a tragedy comparable to the bubonic plague of medieval times. Treatment involves a 30-day series of  injections.

"For the last 60 or 70 years, it's the same old medicine being used to treat these people," Dr Monique Wassuna, director of Kenya's Clinical Research Centre.

Wassuna says diagnosing kala azar could be life-threatening because it involved what is known as a "splenic aspirate." Another option is an extremely painful bone marrow sample. For now, there is no alternative.

"This is how it has always been diagnosed," she said.

KEMRI officials point to a tiny kala azar research lab as evidence of low funding. The room contained dozens of plastic bins -- including one bound together by masking tape -- holding sand flies swarming around a few apple slices. For those hoping for advancement in the fight of Black Death, it's not looking promising unless greater action is taken by local and national governments.