Modelling the impact of COVID-19-related programme interruptions on visceral leishmaniasis in India

Background In March 2020, India declared a nationwide lockdown to control the spread of COVID-19. As a result, control efforts against visceral leishmaniasis (VL) were interrupted. Methods Using an established age-structured deterministic VL transmission model, we predicted the impact of a 6 to 24-month programme interruption on the timeline towards achieving the VL elimination target, as well as on the increase of VL cases. We also explored the potential impact of a mitigation strategy after the interruption. Results Delays towards the elimination target are estimated to range between 0 to 9 years. Highly endemic settings where control efforts have been ongoing for 5-8 years are most affected by an interruption, for which we identified a mitigation strategy to be most relevant. However, more importantly, all settings can expect an increase in the number of VL cases. This increase is substantial even for settings with a limited expected delay in achieving the elimination target. Conclusion Besides implementing mitigation strategies, it is of great importance to try and keep the duration of the interruption as short as possible, to prevent new individuals from becoming infected with VL, and continue the efforts towards VL elimination as a public health problem in India.