Leprosy: Regional elimination on the horizon
Leprosy exists as a health disease in limbo. Too large to be considered eliminated and with too few cases to get the final resources needed for true elimination, there is a common misconception that leprosy is a disease of the past. However, 215 656 people are affected by Leprosy as of September 2014, primarily in Brazil, India and Indonesia.
Overcoming the disease and stigma
Laws exist in many countries of the WHO South-East Asia Region which discriminate against leprosy affected persons and their families. These laws impact chances of employment, marriage and other areas. WHO is working with governments and leprosy partners to reduce these barriers. The Association of People Affected by Leprosy in India fights for the rights of those with leprosy to push for an end to this stigma.
Early detection as a path to eliminating leprosy
Dr Pannikar worked as a WHO expert for 35 years fighting leprosy. He led the successful trail of multi-drug therapy (MDT) which showed results quickly and reduced the global cases of leprosy from 11 million to now under a quarter million.
Now retired, Dr Pannikar continues his work with WHO and partner organizations in what he expects to be the final push. He feels that the global community has overcome the hurdles of developing treatment and ending leprosy is now within our reach. “We are focusing on disclosure of cases to individuals, families and communities. A coming out to doctors and medical staff can only happen when we address the stigma of leprosy. We need to make the public and practitioners partners in leprosy detection, treatment and cure to eradicate leprosy.” says Dr Pannikar.
Since 1995, WHO has provided MDT free of cost in all Member States. Now that the number of leprosy cases has been drastically reduced, WHO is flagging the need for renewed efforts and a focus on zero children with deformities and detecting all new leprosy cases before disability. The last mile in leprosy eradication will need enabling environments where people with leprosy feel enabled to identify themselves and seek treatment.
Leprosy elimination: a WHO flagship
In July 2013, 17 countries came together at the International Leprosy Summit to commit to a global target of less than one case per million by the year 2020 through the Bangkok Declaration. The declaration recommends measures such as including leprosy affected persons in the leprosy control initiatives.
“Every person has a role to play in reducing the leprosy disease burden…”
- Dr Poonam Khetrapal Singh
A major component to achieve this target is preventing childhood leprosy. Given the long incubation period and minor chance for contracting leprosy, cases in children should be a rarity. However, about 10% of new cases are children and many of these cases are advanced with visible deformity.
“We still have a lot of work to do. Every person has a role to play in reducing the leprosy disease burden and removing the age old scourge from the globe. We must coordinate efforts to improve early case detection and help us reach the goal of zero child cases with grade 2 disability by 2020.” said Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia, who has declared leprosy as a Flagship Program which intends to result in zero disability among new child cases by 2020. “It is time to take a deeper look at the social issue that has allowed leprosy to elude elimination - the stigma which prevents early detection and proper treatment.” she added.
The World Health Organization is working with The Nippon Foundation, Novartis Foundation for Sustainable Development (NFSD), International Federation of anti-leprosy associations (ILEP) and the networks of the persons treated for leprosy to create the roadmap for the last mile in leprosy elimination.
Informing about leprosy while evoking a responsible behavioral change in the members of community, diagnosing leprosy and treating the affected well by health professionals are all key areas of the upcoming 2016-2020 global leprosy strategy.
This new WHO strategy will aim to detect all cases before disability sets in and will focus on zero disability cases among children by the end of the decade.