Prevention and Control of Leishmaniasis Amongst Vulnerable and Conflict-Affected Communities in North-West Syria - Envelope 1 and 2 The Syrian Arab Republic is enduring a protracted humanitarian crisis as a result of eleven years of conflict and insecurity, which led to displacements, heavily damaged infrastructure and a lack of basic services. The environment that the conflict has created – destroyed buildings with cracks and crevices, rubble and uncollected waste – has created ideal breeding grounds for sand flies, the vector of leishmaniasis, which has rebounded since the beginning of the conflict. In addition, the presence of a multitude of host reservoirs, such as rodents and canines and the amassing of Internally Displaced Persons (IDPs) in camps with poor living conditions greatly enhances the ability of sand flies to find a blood meal, and subsequently to transmit infection in the process. Other infectious diseases, such as water-borne and further vector-borne diseases are also on the rise. 

Under this project, MENTOR proposes to conduct leishmaniasis medical management activities in areas of Western Rural Aleppo and Northern Idleb that have been identified under this allocation strategy as priority areas due to the high number of recent returnees, the lack of available services and resources as well as a continued high incidence of both forms of leishmaniasis, cutaneous (CL) as well as visceral (VL). MENTOR is currently active in these areas, and proposes to extend its presence through this grant in a bid to control the proliferation of leishmaniasis and to provide acutely needed leishmaniasis health services. In addition, to address the continually high incidence of leishmaniasis in NWS, MENTOR proposes to provide protection from sandfly bites and subsequent disease to 1,611,497 beneficiaries (Annex F) through an Indoor Residual Spraying campaign (IRS) in areas of high leishmaniasis incidence right before the high transmission season, which lasts from April through to September, and will see the residents being protected from leishmaniasis during this period. 

Through this project, MENTOR will continue to partner with stakeholders and communities to ensure that the most vulnerable receive adequate leishmaniasis services through the operation of three mobile leishmaniasis clinics in Aleppo (Jebel Saman district, Daret Azza and Atareb sub-districts) and Idleb (Harim district, Qourqeena and Dana sub-districts / Idleb district, Maaret Tamsrin sub-district) governorates as well as supporting 18 health facilities (HFs) in the same locations with leishmaniasis diagnostic and treatment support through the supply of essential leishmaniasis diagnostic and treatment commodities, including both first- and second-line leishmaniasis drugs, for a duration of 12 months. All sub-districts have high incidence of leishmaniasis and many Internally Displaced people living there. In addition, MENTOR will conduct a large-scale IRS campaign in Aleppo (Afrin district, Ma'btali and Jandairis sub-districts / Jarablus district, Ghandorah and Jarablus sub-districts / Jebel Saman district, Atareb sub-district / A’zaz district, Aghtrin sub-district) and Idleb (Idleb district, Sarmin and Jebel Saman sub-districts / Harim district, Dana sub-district) to break the leishmaniasis transmission cycle in NWS, a disease which has progressed to epidemic proportions in the last years.

The IRS campaign also entails information about leishmaniasis and its transmission to empower communities to protect themselves from leishmaniasis infection and disease. MENTOR will conduct adjacent Information, Education and Communication / Behaviour Change Communication activities to ensure households are empowered to prevent leishmaniasis transmission within their household/shelter and to maximise uptake and correct utilization of leishmaniasis prevention and case management services, as acceptance of the activity is key to achieving a coverage of at least 85% of all eligible households. 

MENTOR has coordinated with the Health and WASH Clusters and gained their approval.