Over the past two decades, more than 14 million people have been cured of leprosy. However, it is estimated that there are more than 2 million people in the world who have disabilities resulting from the disease. Another 2 million are thought to have loss of sensation in their hands and feet, putting them at risk of developing impairment.
People diagnosed with leprosy still face discrimination. For those with disabilities, the discrimination can be especially pronounced, compounded by the misconceptions and misrepresentations that continue to surround the disease. Yet the disabilities associated with leprosy are not unique. And people with disabilities, whatever their cause and condition, are still people.
The long-awaited WHO guidelines on community-based rehabilitation (CBR) that are to be launched this autumn in Nigeria (see p. 2) are aimed at all persons with disabilities, including people affected by leprosy and their families. There will even be a supplementary chapter on leprosy and CBR.
The new guidelines are based on the notion of community-based inclusive development. In this model, all benefit from development initiatives, all live in the community with choices equal to others, all enjoy equal human rights and all live with dignity.
The WHO's Chapal Khasnabis, who has worked long and hard on preparing the guidelines, has described them as "new CBR for a new millennium". He is keen to stress their relevance and applicability to people affected by leprosy and their families, and is anxious for people affected by leprosy to seize the opportunity that the new guidelines provide.
For that to happen, leprosy needs to be part of the disability movement, he says. Otherwise, leprosy will remain in isolation, "a social puzzle," and the pace of change will be slow.