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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

REPORT: Enhanced Global Strategy Takes Shape

Program managers, partners meet in India and agree on new target for 2011-2015.


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The three-day meeting at WHO SEARO in New Delhi achieved consensus on leprosy control strategy for 2011-2015.

A new global target for leprosy has been agreed following a three-day Global Leprosy Program Managers Meeting in New Delhi to discuss leprosy control strategy for 2011-2015.

The new target is a reduction in the rate of new cases with Grade 2 disabilities per 100,000 population by at least 35% by the end of 2015, compared to the baseline at the beginning of 2011. Such a reduction would indicate that leprosy is being detected early before nerve damage leading to impairments and disabilities.

Making new cases with Grade 2 disabilities the key indicator to monitor progress was one of a number of enhancements to the current leprosy strategy for 2006-2010 that emerged from the April 22-24 discussions at the WHO's South East Asia Regional Office.

Delegates included over 40 National Leprosy Program Managers from around the world as well as members of the WHO Technical Advisory Group (TAG) for Leprosy. Also represented were international NGOs and organizations of persons affected by leprosy, the Novartis Foundation for Sustainable Development, which donates the drugs used to treat leprosy, and The Nippon Foundation, which sponsored the meeting.

Under consideration was the Enhanced Global Strategy for Further Reducing the Disease Burden Due to Leprosy (2011-2015). This is formulated as a natural extension of WHO's earlier strategies and intended, along with the accompanying Operational Guidelines, to serve as a basis for each national leprosy program to develop its own country-specific strategy.


HOUSEHOLD CONTACTS

Another enhancement agreed to at the meeting was to examine all household contacts of newly detected cases, as household contacts of leprosy patients are at significantly greater risk of developing leprosy than contacts that are not living in the same household.

Although this was recommended in June 1997 by the 7th WHO Expert Committee, there has only been limited implementation of this strategy due to concerns over exacerbating stigma and difficulties in implementation. However, the re-introduction of this examination policy is regarded as a positive step that could have the potential to detect cases earlier and prevent disabilities, even though much remains to be discovered about infection and transmission of leprosy.

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National program managers Dr. Jean Norbert L. Mputu (DR Congo) and Dr. Alcino Ndeve (Mozambique)

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Professor Diana Lockwood of the London School of Hygiene & Tropical Medicine is flanked by LEPRA's Terry Vasey and Dr. P V Ranganadha Rao.

The Enhanced Global Strategy will be further boosted by:

- Reinforcement of the humanitarian issues and rights of people affected by leprosy and absolute assurance of equity and social justice

- Rigorous advocacy of the use of more dignifying terminology whenever talking about or referring to people affected by leprosy

- Stress on the particular needs for improved leprosy control in underserved areas including urban slums and migrant populations

- Highlighting of opportunities to explore publicprivate partnerships

- Assurance of quality clinical services

- Training of peripheral health workers so they can refer people affected by leprosy to the appropriate services according to their personal needs

- More holistic assessments of the needs of each person affected by leprosy and provision of appropriate support under community based rehabilitation.

- Promoting further research in the area of chemoprophylaxis for future use as a control measure and in developing better treatment regimens with shorter duration of treatment.

On the question of drug security, the Novartis Foundation reiterated its commitment to providing the drugs used in multidrug therapy (MDT) free of charge.


GUIDING PRINCIPLES

Underpinning the Enhanced Global Strategy will be a renewed commitment to the main principles of leprosy control outlined in the current strategy, namely, the timely detection of new cases and their treatment with MDT, and quality patient care that is equitably distributed, affordable and easily accessible. These will continue to form the basis of the strategy for 2011-2015.

Participants had had several opportunities in the months leading up to the meeting to submit their comments and feedback on earlier drafts of the Enhanced Global Strategy and the accompanying Operational Guidelines. As a result of this consultative process, the meeting was able to concentrate on the enhancements that had been proposed.

In a statement, the WHO said: "A great deal of serious thought and deliberation, considerable time and effort has been dedicated to finalizing this global leprosy strategy. The interest and ideas of those who have contributed to this process is evidence of the clear and continuing commitment to provide quality care for all individuals affected by leprosy wherever they are in the world, and to build on the considerable progress already made in reducing the burden of this disease."


Leprosy FACT

At the beginning of 2008, a total of 218,605 leprosy cases were registered for treatment in the world. The number of new cases reported during 2007 was 258,133.