US embassy cable - 05BOGOTA8545

S E C R E T BOGOTA 008545 
 
SIPDIS 
 
PLEASE PASS TO SONJA MADERA DHHS/NIH/FIC 
 
E.O. 12958: DECL: 08/31/2015 
TAGS: ECON, PARM, SOCI, CO 
SUBJECT: THE EFFECTS OF LEISHMANIASIS IN COLOMBIA 
 
REF: SECSTATE 138350 
 
Classified By: DCM Milton Drucker for Reasons: 1.4 (b) and (d) 
 
 
1.  (S)  Leishmaniasis, the parasitic disease spread by the 
bite of infected sand flies, is a disease plaguing the 
military and rural poor in Colombia.  Reported civilan cases 
have risen from 4,000 in 1990 to nearly 10,000 in 2003 to a 
record 13,000 in 2004.  Growth in outbreaks within the 
Colombian Army has been proportionate to outbreaks within the 
general Colombian public.  Within the last year and a half, 
the Colombian military reported 11,000 cases of 
Leishmaniasis.  In comparison, 455 soldiers died and 1,713 
were wounded in 2004 fighting the Revolutionary Armed Forces 
of Colombia (FARC).  During that same year, Leishmaniasis was 
the direct or indirect cause of removing 3,400 soldiers from 
combat. 
 
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Effect on the military 
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2.  (S)  Leishmaniasis is present throughout areas where the 
Colombian military and FARC are present.  The standard 
treatment for the parasite requires intermuscular injections 
of 10 to 15 milliliters of Glucantime each day for 20-30 
days.  Because of the toxicity of the drug, a patient's blood 
chemistry must be closely monitored.  The treatment of 
leishmaniasis also requires that patients be kept out of the 
sun and heat.  However, this is very difficult to do in many 
of the areas where the armed conflict is taking place.  As a 
result, the soldiers, recovery period is generally longer 
than usual.  In an attempt to improve treatment for infected 
soldiers, the government is now moving them out of their 
units to receive treatment in Bogota or at Silva Plazas' 
mechanized calvary group in Duitama, Boyaca. 
 
3.  (S)  The disease is also affecting the GOC's canine bomb 
detection units.  Once dogs are infected, they are 
immediately euthinized as dangerous carriers of the parasite. 
 This has had an adverse affect on morale in the canine 
units, as many of the handlers have been partnered with their 
dogs since they were puppies. 
 
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Limited Treatment Options 
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4.  (S/NF)  The GOC has struggled with providing preventive 
measures for many troops.  Although uniforms are often 
impregnated with insect repellent, after months of constant 
wear, rain, and sweat, such measures loose their 
effectiveness.  Some troops have turned to repellent soaps 
and lotions to help combat the disease, but these products 
have been hard to supply to remote areas.  Unfortunately, the 
GOC has found there is still a high incidence of the disease 
amongst soldiers who use the Nopikex soap and other 
repellents. 
 
5.  (S/NF) Between January and March 2005, the Colombian 
military treated 2,127 patients with 142,175 ampoules of 
Glucantime, at a cost of USD 497,612.  Sanofi Aventis, the 
sole manufacturer of Glucantime, is no longer producing 
enough of the drug to meet Colombian demand due to 
profitablity concerns.  The Colombian military is currently 
looking into alternative therapies, such as miltefosine, 
although studies show this is a less effective drug. 
 
6.  (U) The Embassy, through MilGroup and SOUTHCOM, is not 
permitted to provide funding for most drugs that treat 
leishmaniasis because they are not approved by the U.S. Food 
and Drug Administration.  The experimental drug Pentostam, 
currently in trials in the United States, is not effective 
against most strains of leishmaniasis found in Colombia. 
 
7.  (S//NF)  This year the USG, through SOUTHCOM, provided 
the Colombian Army with USD 500,000 of insect repellent which 
included DEET and Permethrin.  Although many soldiers have 
found the repellent to be effective, the Colombian military 
would prefer additional U.S. technical support in the area of 
early diagnosis and identification of the parasite strain, 
which would enable the Colombian Army medical teams to make 
more effective use of Glucantime and antibiotic supplies in 
the fight against the disease. 
DRUCKER