For decades, Kala-Azar, or visceral leishmaniasis, was one of India’s deadliest neglected diseases, disproportionately affecting poor families across Bihar, Jharkhand, eastern Uttar Pradesh and West Bengal.
Patients often endured a month-long treatment involving 15 intravenous injections and prolonged hospitalisation, leading to lost wages and severe financial hardship.
A landmark 2010 study led by Prof. Shyam Sundar of Banaras Hindu University demonstrated that a single dose of liposomal amphotericin B could cure the disease with a success rate of nearly 96 per cent, dramatically reducing treatment time and improving accessibility.
Alongside introducing rapid diagnostic strip tests that cut detection time from weeks to minutes, his work helped reshape treatment protocols and strengthen India’s Kala-Azar elimination efforts.
Public health experts, policymakers and international health agencies have since recognised these innovations as key contributors to India’s significant decline in cases, bringing the country closer to eliminating a disease that once claimed thousands of lives annually.
One Dose, Millions Saved
For some of India’s poorest communities, Kala-Azar was more than a disease it was often a sentence to prolonged suffering, debt and, in many cases, death. Transmitted through infected sandflies, the parasitic illness attacks internal organs and can be fatal if left untreated.
Until the late 2000s, patients commonly underwent 15 alternate-day infusions of amphotericin B over nearly a month, requiring lengthy hospital stays and exposing them to potentially serious side effects, including kidney damage and cardiac complications.
Witnessing these challenges firsthand through decades of clinical work in Bihar and neighbouring regions, Prof. Shyam Sundar and his team at Banaras Hindu University sought a simpler solution.
Their groundbreaking research, published in the New England Journal of Medicine in 2010, found that a single high-dose infusion of liposomal amphotericin B achieved a cure rate of approximately 95.7 per cent, comparable to conventional treatment.
The breakthrough transformed patient care by reducing hospitalisation from weeks to a single visit, allowing daily wage earners to return to work sooner and significantly lowering the social and economic burden of the disease.
Sundar also played a pivotal role in validating rapid rK39 diagnostic tests, enabling healthcare workers to detect Kala-Azar within minutes rather than relying on invasive procedures and lengthy laboratory processes.
Speaking previously about the need for accessible healthcare solutions, Prof. Sundar has emphasised that treatment innovations must account for the realities faced by vulnerable communities, where missing work for weeks can be as devastating as the illness itself.
From Research To Public Health Success
The impact of these innovations extended far beyond scientific journals. Following the success of the single-dose treatment regimen, national and international health agencies incorporated the findings into broader Kala-Azar control strategies.
The World Health Organization and public health authorities supported expanded access to liposomal amphotericin B, while donation programmes helped make the previously expensive medicine available free of cost to patients in endemic regions.
Combined with strengthened surveillance, vector control measures and early diagnosis initiatives, these efforts contributed to a dramatic reduction in Kala-Azar incidence across India over the past decade.
Areas that once reported recurring outbreaks have witnessed historically low transmission levels, marking a remarkable turnaround in the country’s fight against one of its most persistent neglected tropical diseases.
Health experts have frequently cited the combination of rapid diagnostics and simplified treatment protocols as critical factors behind India’s progress towards elimination targets.
While challenges such as post-kala-azar dermal leishmaniasis and continued surveillance remain, the disease no longer carries the same devastating impact it once had on rural communities.
Prof. Sundar’s work demonstrates how locally driven scientific research can influence national policy and improve healthcare outcomes for millions, particularly those who often have the least access to quality medical services.
The Logical Indian’s Perspective
The story of Prof. Shyam Sundar highlights the transformative power of science when it is guided by empathy and a commitment to social justice. Healthcare innovations are often celebrated for their clinical success, but their true value lies in how they improve people’s lives, especially those living on the margins.
By helping create a treatment that reduced hospital stays from weeks to a single day and supporting diagnostic tools that brought faster detection to remote communities, Prof. Sundar’s work challenged the idea that poverty should determine access to life-saving care. His contribution serves as a reminder that meaningful progress emerges when research addresses real-world inequalities and prioritises human dignity alongside medical advancement.
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