This child lives in South America in a region home to sand flies and mosquitoes. For the last year he’s suffered from intermittent fevers, weight loss, and cough. His stools have been loose and foul smelling. His family reports that this lesion on his cheek ulcerates, heal spontaneously, and ulcerates again. From which disease of poverty is he suffering? One of the ‘classic’ tropical diseases: cutaneous leshmaniasis. Disease manifestations include skin or mucocutaneous disease or visceral disease (kala-azar). WHO estimated global burden from this disease at 2.4 million life years lost and 59,000 deaths for 2001. Pentavalent antimonials, such as sodium stibogluconate and meglumine antimoniate, are used for treatment of visceral and cutaneous disease. Prevention and control measures include using pesticides against sand flies, permethrin-coated fine netting and measure to eliminate leishmaniasis in dogs.