FEATURE-UK 援助（する） 削減（する）s 誘発する 恐れるs over parasitic 殺し屋 that stalks the poor
By Nita Bhalla and Naimul Karim
KACHELIBA, Kenya / DHAKA, July 07 (Thomson Reuters 創立／基礎) - A t first, 5-year-old Msto Pushen's family thought his fever and malaise could be 治療（薬）d by giving him some 地元の herbs.
When that didn't work, they carried him on foot from their village in western Kenya some hours across the 半分-arid scrub to a clinic where he was 手渡すd malaria pills and sent home.
But as the weeks passed, the boy's 条件 より悪くするd: his 負わせる dropped by almost a third, his belly ballooned, and he became so weak he could barely stand.
"No one knew what was wrong with him," said his grandmother Cheparsub Kapelile as he lay on the metal-でっちあげる，人を罪に陥れるd hospital bed in West Pokot, 近づく the Kenya-Uganda 国境.
"It was two months before we learnt about this hospital. We travelled over 1,000 km (620 miles) on a motorbike taxi and then a bus to get here. It was a very difficult 旅行, but he would have died さもなければ."
For those 苦しむing from the deadly 熱帯の 病気, visceral leishmaniasis (VL), the 政府-run Kacheliba 地区 hospital is a rare lifeline.
It is one of only a handful of 施設s across the developing world equipped to 扱う／治療する the parasitic 病気, whose 指名する is unfamiliar to most, but whose 衝撃 can be 破滅的な.
The good news is that 重要な 進歩 has been made in South Asia. Since 2005, when India, Bangladesh and Nepal 調印するd an 協定 to 除去する VL, the number of 事例／患者s 報告（する）／憶測d 毎年 has fallen by 90% によれば the World Health Organization (世界保健機構).
But much of the 最近の 成果／努力 has been 基金d by Britain, which in 2019 開始する，打ち上げるd a three-year programme to 取り組む VL and four other neglected 熱帯の 病気s (NTDs) - preventable or curable 病気s that おもに 衝撃 the poor, often stopping them from working and trapping them in poverty.
Britain has been a 全世界の leader in 取り組むing NTDs, but its 220 million 続けざまに猛撃する ($305 million) progr amme is ending 早期に 予定 to a 4 billion 続けざまに猛撃する 援助（する） spending 削減（する）, a move the 世界保健機構 says will 原因（となる） thousands of needless deaths.
栄冠を与える スパイ／執行官s, which manages the programme, said it was talking to the 政府 about the 衝撃 of the 削減（する）s, which come as health systems around the world are already grappling with the 圧力 of a pandemic.
"The seismic 衝撃 of the pandemic 軍隊d the 堅い 決定／判定勝ち（する） to 一時的に 減ずる the 援助（する） 予算," a British 政府 spokesperson said in an emailed 声明.
"We continue to 分配する 麻薬s to fight neglected 熱帯の 病気s and 成し遂げる 外科s in the most 緊急の 事例／患者s," said the 声明, 追加するing that Britain was working to 出口 programmes responsibly and mitigate the 衝撃 of the 削減（する）s.
'POOREST OF THE POOR'
VL, also known as Kala Azar, is the deadliest parasitic 病気 after malaria.
Transmitted through sandfly bites, the parasite multiplies and attacks the 免疫の system, 原因（となる）ing fever, 負わせる loss, enlargement of the 肝臓 and spleen, and anaemia.
It afflicts up to 90,000 people in nearly 70 countries every year.
Britain's 加速するing the 維持できる 支配（する）／統制する and 排除／予選 of Neglected 熱帯の 病気s (ASCEND) programme, which operates VL programmes in Ethiopia, Kenya, Sudan, South Sudan, Uganda, Nepal and Bangladesh, was 予定 to run until March 2022.
The 世界保健機構 警告するd its 終結 would mean 20,000-30,000 more deaths from VL, which is almost always 致命的な if not 診断するd and 扱う／治療するd on time.
MPs from Britain's 判決，裁定 and 野党s have 警告するd the move punished the poorest during a 全世界の pandemic, while on Saturday more than 30 former African leaders decried the 削減（する）s, calling for a 地域の 押し進める to 回避する a "ferocious calamity".
Health charities and 選挙運動者s have also criticised the move.
"VL 支配（する）／統制する programmes in East Africa, for example, support over 10,000 患者s each year and have been fully 扶養家族 on UK 基金ing for diagnostics, 麻薬s and other support," said Vic kie Hawkins, (n)役員／(a)執行力のある director of Medecins Sans Frontieres (MSF) UK.
"They will 崩壊（する） 完全に に引き続いて the 援助（する） 削減（する）s."
At the Kacheliba hospital, young children with swollen bellies 嘘（をつく） two to a bed under mosquito 逮捕するs.
医療の superintendent Solomon Tokey said 患者s tended to come to the hospital late as the 病気 was often misdiagnosed and the 治療 was slow and difficult. "The 病気 影響する／感情s the poorest of the poor," said Monique Wasunna, Africa director of the 麻薬s for Neglected 病気s 率先 (DNDi), which 基金s the VL department at Kacheliba hospital.
"They live in the middle of nowhere and they are voiceless. They are not on the レーダ of big 産業s or 政府s.
"As a result, the 病気 remains neglected, 特に ーに関して／ーの点でs of 投資 for the 研究 and 開発 of 改善するing diagnosis and 治療."
RESURGENCE RISK
In Bangladesh, which has almost 除去するd VL with support from the ASCEND programme, health 公式の／役人s worry the 援助（する） 削減（する）s could lead to a resurgence.
ASCEND 基金s, used to spread 認識／意識性 and （悪事，秘密などを）発見する new 事例／患者s, were stopped in June, meaning that work will soon end.
Bangladeshi health 公式の／役人 Abu Nayeem said the 政府 was looking for new 基金ing sources.
But 基金ing for NTDs, always in short 供給（する）, has been 攻撃する，衝突する by the COVID-19 pandemic, said Dinesh Mondal, a Bangladeshi 研究 scientist who sits on the 世界保健機構's （a）忠告の／（n）警報 パネル盤 for parasitic 病気 支配（する）／統制する.
"Just because the number of 事例／患者s have dropped, doesn't mean we can breathe 平易な. Even a 選び出す／独身 患者 can 徐々に lead to an 突発／発生," he said.
"We need a new 治療 for this 病気. There are lots of ideas, but not enough 基金ing ... even most of the 競争の激しい 認めるs today go to COVID-based 研究."
治療s 変化させる but can be 非常に長い and expensive. In East Africa, 患者s must be hospitalised for 17 days of 注射s, 緊張するing already 貧しく 資源d health 施設s.
The DNDi is 反対／詐欺 導管ing 臨床の 裁判，公判s to find an oral 治療, but Wasumma said few 寄贈者s 手配中の，お尋ね者 to support VL 研究.
Kenya said it had received no 公式の／役人 communication on the 援助（する） 削減（する）s, but a health 省 公式の／役人 told the Thomson Reuters 創立／基礎 関心 was growing.
VL is endemic in nine of Kenya's 47 郡s - remote, arid or 半分-arid 地域s 住むd 大部分は by pastoralist communities that are hard to reach with public health （警察などへの）密告，告訴（状）.
Most 患者s are men and boys who take their herds long distances for grazing and often sleep outside, leaving them exposed to sandfly bites.
"We have many 優先s such as HIV/エイズ, malaria and tuberculosis and so we are very 扶養家族 on our foreign partners' support to our VL programmes," said the Kenyan 公式の／役人, who 拒絶する／低下するd to be 指名するd as he was not authorised to speak to the マスコミ.
"We were planning to 行為／行う training in さまざまな 郡s of community health 労働者s so they can reach out to remote 全住民s. This would help to 強化する 早期に 診断するs and 治療. Now, we are not so sure." ($1 = 0.7223 続けざまに猛撃するs) (報告（する）／憶測ing by Nita Bhalla @nitabhalla and Naimul Karim, Editing by Claire Cozens. Please credit the Thomson Reuters 創立／基礎, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live 自由に or 公正に／かなり. Visit http://news.信用.org)
