The target set by the WHO to reduce the prevalence rate of leprosy to below one case per 10,000 population in each country by 2005, and so eliminate the disease as a public health problem, has yielded impressive results. The approach has not been without its critics, however. Among other things, they feared that when a country achieved 'elimination,' this would mislead people into thinking that leprosy had been consigned to history. While this criticism may be valid for some countries, it is not for others.
India, which accounted for about 54% of the world's new cases of leprosy in 2007, achieved the elimination goal several years ago yet remains committed to tackling the disease. Treatment has been integrated into the general health services and the government is strengthening rural health programs. India has a clear vision of completely eradicating the disease in the foreseeable future. By contrast, Indonesia and some African countries need to do more if they are simply to sustain the achievement.
Among the three countries yet to achieve elimination, Nepal and Timor Leste will likely do so this year. The country facing the biggest challenge is Brazil. President Lula, more than most leaders, truly cares about the lives of people affected by leprosy. Given the interest taken by the head of state, it is all the harder to understand why Brazil lags behind in reaching elimination. There must be a reason for this.
I hope the government and other experts in Brazil examine the situation, pinpoint the causes and address them in a timely manner. While respecting Brazil's intentions, the WHO and its partners must do what they can to assist the country more vigorously than ever. I myself am willing to go there as often as required.
The day cannot come quickly enough when every country in the world has moved past the elimination milestone. By now, we should all be focused on reducing the disease burden further and setting our sights on the ultimate goal of eradicating the disease altogether.
- Yohei Sasakawa, WHO Goodwill Ambassador