WHO launches new global strategy seeking accelerated efforts to end leprosy

New Delhi: WHO last week launched a new global strategy for leprosy calling for stronger commitments and accelerated efforts to stop disease transmission and end associated discrimination and stigma, to achieve a world free of leprosy.

“The new global strategy is guided by the principles of initiating action, ensuring accountability and promoting inclusivity. These principles must be embedded in all aspects of leprosy control efforts. A strategy can only be as good as its implementation,” Dr. Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region, said at the launch of the global strategy for 2016-2020 ‘Accelerating towards a leprosy-free-world’ in New Delhi.

The strategy aims to, by 2020, reduce to zero the number of children diagnosed with leprosy and related physical deformities; reduce the rate of newly-diagnosed leprosy patients with visible deformities to less than one per million; and ensure that all legislation that allows for discrimination on the basis of leprosy is overturned.

The key interventions needed to achieve the targets include– detecting cases early before visible disabilities occur, with a special focus on children as a way to reduce disabilities and reduce transmission; targeting detection among higher risk groups through campaigns in highly endemic areas or communities; and improving health care coverage and access for marginalized population. 

Screening all close contacts of leprosy affected persons, promoting a shorter and uniform treatment regime; and incorporating specific interventions against stigma and discrimination are the other strategic interventions that endemic countries need to include in their national plans to meet the new targets.

The new strategy builds on the success of previous leprosy control strategies. It has been developed in consultation with national leprosy programs, technical agencies and NGOs, as well as patients and communities affected by leprosy. The strategy focuses on equity and universal health coverage which will contribute to reaching Sustainable Development Goal on health.

The main and continuing challenges to leprosy control have been the delay in detection of new patients and persisting discrimination against people affected by leprosy which has ensured continued transmission of the disease.Several leprosy-affected countries still have legislation in place that allows discrimination against people suffering from leprosy. 

Social stigma impedes early detection of the disease, particularly in children, and increases disabilities.Stigma also facilitates transmission among vulnerable groups, including migrant populations, displaced communities, the ultra-poor and hard-to-reach population. Combatting stigma and ensuring early diagnosis through active case-finding, which the new strategy emphasizes, is critical to making progress.

Leprosy was eliminated globally in the year 2000 with the disease prevalence rate dropping to below 1 per 10 000 population. Though all countries have achieved this rate at the national level, at the sub-national level, it remains an unfinished agenda. Leprosy continues to afflict the vulnerable, causing life-long disabilities in many patients, subjecting them to discrimination, stigma and a life marred with social and economic hardships.

Of the 213 899 new cases in 2014, 94% were reported from 13 countries – Bangladesh, Brazil, Democratic Republic of Congo, Ethiopia, India, Indonesia, Madagascar, Myanmar, Nepal, Nigeria, the Philippines, Sri Lanka and the United Republic of Tanzania. India, Brazil and Indonesia account for 81% of the newly diagnosed and reported cases globally.