The overall target, set ten years ago, for the global elimination of leprosy as a public health problem has been attained, the World Health Organization (WHO) and its partners announced today. Those involved in this effort hailed reaching this goal as a major achievement.
In 1991, WHO Member States resolved to decrease the level of leprosy in the world by over 90%. This has now been accomplished.
"Together, we can take pride in this victory in reducing to very low levels one of the most dreadful diseases to have ever afflicted mankind. WHO would like to express its gratitude for the strong support of our partners. Today, no one should have to suffer the stigma, deformity and disability wrought by this curable disease," said Dr Gro Harlem Brundtland, WHO Director-General.
To achieve this dramatic reduction of the disease burden, the leprosy elimination effort has increased access to early diagnosis and free cure in communities at risk.
The key force in the leprosy elimination effort is the Global Alliance for the Elimination of Leprosy. Currently chaired by India, it is spearheaded by the national programmes of major endemic countries, WHO, The Nippon Foundation, the International Federation of Anti-Leprosy Associations (ILEP), Novartis and the Novartis Foundation for Sustainable Development, Danish International Development Assistance (DANIDA) and the World Bank. Created in 1999, this formal Alliance was the natural successor of a little known, but highly effective, partnership actively fighting the disease over the last decade.
Efforts turn to meeting target at national level with main focus on six countries
The victory on the global level now needs to be reproduced on every national level, as a handful of countries still need to drive the prevalence of leprosy down further. The biggest challenges of the leprosy elimination programme lie ahead: reducing the leprosy burden in remaining endemic countries, and bringing leprosy services closer to all communities in need.
"The main priority now is to urgently improve access to multidrug therapy for communities that we haven’t been able to reach before, because of poor coverage of leprosy services, lack of infrastructure, isolation or war," said Dr Maria Neira, Director of WHO's Department of Communicable Disease Control, Prevention and Eradication.
Full control of leprosy has eluded mainly six countries: Brazil, India, Madagascar, Mozambique, Myanmar and Nepal. These countries are committed to stepping up leprosy control activities.
For instance, "India is maximizing the availability of resources for leprosy through the World Bank and other Alliance partners. Action is being taken for full integration of Leprosy Control within the general health services so that better services will be delivered to communities that are most affected by the disease," said Dr Chandreshwar Prasad Thakur, Union Minister for Health and Family Welfare, Government of India. The majority of the world's cases of the disease are in India.
Access to information, diagnosis and treatment with multidrug therapy is essential
Information campaigns about leprosy in high risk areas are crucial so that patients and their families, who were historically ostracized from their communities, are encouraged to come forward and receive treatment.
The Nippon Foundation reaffirmed its commitment to support the final years of the struggle against the disease. "We must take every possible opportunity to raise our voices and spread this message: Leprosy is curable. Treatment is free. Discrimination must end. This must be expressed as strongly as possible in every possible place. We must join together to form a united front powerful enough to win over our adversary ― leprosy," said Mr Yohei Sasakawa, President of The Nippon Foundation and Special Ambassador for the Global Alliance.
Today, diagnosis and treatment of leprosy is easy. Essential work is being carried out to integrate leprosy services into existing, general health services. This is especially important for communities at risk for leprosy, which are often the poorest of the poor and under-served.
Mr Terry Vasey, President of ILEP, warns that "unless services are truly integrated into general health services, there is a danger that anti-leprosy activities will not be sustainable. The fight against the disease must be continued as long as people are unnecessarily handicapped and stigmatized because of leprosy."
Leprosy is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated, infected persons. Leprosy mainly affects the skin and nerves, and if untreated can cause progressive and permanent damage to the skin, nerves, limbs and eyes.
Treatment with multidrug therapy is highly effective. It stops transmission of the disease starting with the first dose, and prevents disabilities. Over the past 15 years, about 11 million leprosy patients have been cured with this treatment. Multidrug therapy consists of three drugs which need to be taken by the patient for six or 12 months, depending on the severity of the disease.
Novartis offers strong support through WHO in the form of free multidrug therapy drugs until at least the end of 2005, which would cure between 2.5 and 2.8 million patients during the intervening period. "We are pleased to provide high quality treatment, free of charge, to all leprosy patients around the world and thereby help to eliminate this disabling disease from every country," said Dr Daniel Vasella, Chairman and Chief Executive Officer of Novartis.
Leprosy is an ancient disease, first mentioned in writing in 600 B.C. Modern science has achieved a major breakthrough recently with the mapping of the genome of the bacillus Mycobacterium leprae. This has opened up new avenues for developing diagnostic tests for leprosy, which can incubate in the human body for up to 20 years, before the telltale signs ― insensitive patches on the skin ― are observed.
The Global Alliance is taking all effective measures to ensure that leprosy fades out for good, and that the last few endemic countries of the world will soon celebrate their own national victory over the disease.