New book to examine emergence of effective international effort against leprosy.
In June 1949, a delegation from the Government of India took a memorandum on leprosy to the Second World Health Assembly. The World Health Assembly (WHA), the World Health Organization, and the Government of India were all newly born; leprosy, on the other hand, was an ancient disease.
The year before, the Interim Commission for the First World Health Assembly had decided that diseases such as cancer and leprosy did not "lend themselves easily to international action."
The commission had argued that "Nothing really useful can be done to fight these diseases at the present stage of medical knowledge … the Organisation's entire budget would be merely a drop in the ocean."1 Instead, they decided that diseases such as malaria, tuberculosis and venereal disease would be targeted first.
But by the time of the Second World Health Assembly, a change had taken place; leprosy had been accepted as a new subject for action. The Chronicle, the journal that recorded all the actions and decisions of the WHA, stated that "cogent arguments" had been made for an international campaign to combat leprosy.
'Highest Priority '
The delegation from India had been very persuasive, informing the assembly that 5 million people suffered from leprosy in both tropical and subtropical regions and that it was a "public health problem of great importance." Furthermore, the prevalence of leprosy was so high in certain countries in Asia and Africa that it should receive the "highest priority" in the "national health programmes" of those countries. 2
The delegation explained very briefly what was known about leprosy and how much was still uncertain. In addition to the scientific uncertainties, it stated that the administrative and social problems were immense. The people who suffered most from leprosy were the poorest, living in crowded and abject conditions, and countries where leprosy was an important public health problem were the least equipped to deal with the expense and had the least developed health services. The delegation also argued that there was hope from a new therapeutic sulphone, but there was a great need for more research.
This key delegation was led by Rajkumari Amrit Kaur, the minister for health in the new Cabinet of independent India. She had also been the former vice president of the First World Health Assembly. 3
Writing later that year to T.N. Jagadisan, a famous intellectual and spokesperson for people affected by leprosy, she told him: "I feel a special responsibility towards the cause of leprosy not only because I knew Bapu's mind about it and would like to do something tangible for it, but also because I have brought it before WHO and my proposal received a most favourable reception in Rome last June… ."4 Of course, in referring to Bapu she was referring to Mahatma Gandhi.
|Members of the consultative committee for the book, including coauthors Dr. Jo Robertson (front, second from right) and, seated next to her, Professor Bernardino Fantini.|
This was the beginning of an international effort against leprosy that has brought us to where we are today. I am now in the process of writing a book about this with Professor Bernardino Fantini. Conceived by Dr. Yo Yuasa and Dr. S.K. Noordeen, and funded by The Nippon Foundation, the project is based in Geneva at Institut d'Histoire de la Medecine et de la Sante, Centre Medicale Universitaire, which is a WHO collaborating center. Professor Fantini is the institute's director.
Our study of the recent history of leprosy will focus on the dynamic between M. leprae and the work against it. It will show the emergence and development of activities to tackle leprosy, culminating in public health strategies that changed leprosy from being a problem without a solution to one that could be dealt with. It will trace the long-standing history of international activities against the disease that merged into effective global health initiatives at local, national and international levels.
We will also analyze the tradition of compassion and benevolence that has always been intertwined with leprosy work, and the way in which this is connected to advocacy of the human rights of people affected by the disease. Of particular interest, I believe, will be the changing local, national and international strategies of control and elimination in the context of other health strategies.
Publication is planned for 2011.
AUTHOR: Dr. Jo Robertson
Dr. Jo Robertson was the coordinator of the International Leprosy Association's Global Project on the History of Leprosy between 2001 and 2007 and is now at the Institut d'Histoire de la Medecine et de la Sante, Centre Medicale Universitaire.
1 Chronicle Vol.II, No. 8-9 (Aug-Sept 1948), p. 171
2 Second World Health Assembly: 1 June 1949 "Leprosy: Memorandum Submitted by the Delegation of the Government of India" (A2/40 1 June 1949, Supplementary Agenda Item 22.214.171.124) (471/1/1), p. 1
3 On 24 June 1948 in Geneva, she had been elected as one of three vice presidents of the inaugural assembly Chronicle Vol.II, No. 8-9 (Aug-Sept 1948), 164
4 Correspondence from Amrit Kaur to Jagadisan, October 28, 1949, cited in T. N. Jagadisan, Fulfilment Through Leprosy, (India: Kasturba Kushta Nivaran Nilayam, 1988), p. 159