HEALTH: Final Assault on Leprosy

By Gustavo Capdevila Reprint | | Print |

Gustavo Capdevila

GENEVA, Nov 15 1999 (IPS) - The World Health Organisation (WHO) announced the creation of a Global Alliance aimed at eliminating leprosy as a public health threat in the world by the year 2005.

The objective of the new campaign, “the Final Push”, is to detect and cure the remaining cases of leprosy in the world, estimated at between 2.5 and 2.8 million.

The Alliance is comprised of WHO, the governments of the countries hit hardest by the disease, the Nippon Foundation, the International Federation of Anti-Leprosy Associations (ILEP), the Danish International Development Agency (DANIDA), the World Bank and the pharmaceutical giant Novartis.

WHO explains that in the case of leprosy, “elimination” is seen as “bringing down the disease burden to a very low level, which will lead to a reduction in the source of infection so that the disease will disappear naturally as it did in many parts of the world.”

That level has been set by the global health agency at less than one case per 10,000 inhabitants.

The new 2005 deadline updates the goal set in 1991, when the World Health Assembly proposed reducing the rate of the disease to less than one case per 10,000 people by the year 2000.

A year before that deadline, WHO found that the rate remained four times higher than the target in the 12 countries which account for 90 percent of all leprosy cases: Angola, Burma, Brazil, Guinea, India, Indonesia, Madagascar, Mozambique, Nepal, Niger, the Central African Republic and the Democratic Republic of Congo.

Among the reasons for the failure to make the deadline, WHO cited the fast spread of the disease and the limited geographic coverage achieved by the Multidrug Therapy (MDT), which consists of three drugs: dapsone, rifampicin and clofazimine.

In several countries shaken by internal conflicts, the deterioration of health infrastructure has also conspired against efforts to eliminate leprosy.

One of the chief reasons for the failure to meet the 2000 deadline was the discovery of a number of cases that had previously gone undetected, due mainly to a lack of access to diagnosis and treatment, lack of familiarity with the early symptoms of the disease, and delay in seeking medical care due to the social stigma attached to leprosy.

The effects of delayed diagnosis and treatment can be devastating for people suffering from leprosy as well as their families, as the disease can lead to progressive, irreversible deformities, WHO pointed out.

The new offensive will be a continuation of the previous strategy, based on campaigns to detect cases of leprosy, and the administration of MTD, which has proven effective as a well- tolerated cure for leprosy, with a very low relapse rate.

The winning card of the campaign will be the involvement of all health services in the countries where leprosy is a public health problem. The aim is to ensure availability of the three medicines used in the MTD, free of cost, over the next six years.

The strategy will include activities to raise community awareness of the need to seek treatment at the first appearance of symptoms, as well as follow-up measures and several corrective actions.

In the 12 abovementioned countries, the incidence of the disease presently stands at 4.5 times the target rate.

India, where leprosy is most prevalent, has offered its capital, New Delhi, as headquarters for the coalition set up for the final attack on the disease.

Addressing the Third International Conference on the Elimination of Leprosy, running Monday through Wednesday in Abidjan, the capital of Ivory Coast, WHO Director Gro Harlem Brundtland said “we are grateful for the strong support of our partners in the final years of the fight against leprosy.

“Let us join hands and make a final push to consign a dreaded disease to history.”