02854nas a2200373 4500000000100000008004100001653003900042653001800081653001500099653002200114653003300136653002400169653003100193653001800224653001100242653002800253100001800281700001800299700001900317700001600336700001200352700001600364700001100380700001100391700001400402700001200416700001400428245009300442856009800535300001300633490000700646520181300653022001402466 2017 d10aNeglected tropical diseases (NTDs)10aLeishmaniasis10aBangladesh10aCapital Financing10aCommunicable Disease Control10aDisease eradication10aEpidemiological Monitoring10aHealth Policy10aHumans10aLeishmaniasis, Visceral1 aFitzpatrick A1 aAl-Kobaisi NS1 aBeitman Maya J1 aRen Chung Y1 aDuhan S1 aElbegdorj E1 aJain S1 aKuhn E1 aNastase A1 aAhmed B1 aOlliaro P00aSustaining visceral leishmaniasis elimination in Bangladesh - Could a policy brief help? uhttp://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0006081&type=printable ae00060810 v113 a

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.

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