After treating more than 13,000 people afflicted with kala-azar, Médecins Sans Frontières looks toward closing shop by the end of August and passing the ropes to the government of Bihar, India’s poorest state.
Also known as black fever or visceral leishmaniasis, kala-azar is a neglected tropical disease transmitted by the bite of a sand fly. Kala-azar affects the poorest of the poor and, if left untreated, will ultimately be fatal. Symptoms include fever, enlargement of the spleen and liver, loss of appetite and weakness.
Kala-azar is also endemic in Bihar, an eastern Indian state on the south bank of the Ganges River with a population of 100 million. Bihar has made progress in combating poverty, but more than 30 percent of people there still live below the poverty line, well above the national average.