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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

AMBASSADOR’S JOURNAL: To Geneva and Back

Meetings with health ministers and officials on the sidelines of the 64th World Health Assembly, and laying the groundwork for Global Appeal 2012.

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Sasakawa Health Prize winner, Dr. Eva Siracká (2nd from left) at the awards ceremony.

SWITZERLAND (May 17-20)

In May I traveled to Geneva for the 64th World Health Assembly. There I presented the 27th Sasakawa Health Prize, awarded annually for innovative work in health development. This year's winners were Dr. Eva Siracká from Slovakia, president of the Slovak League against Cancer, and The Pequeña Familia de María Brotherhood from Panama, an NGO providing assistance to people of all ages with HIV/AIDS.

But leprosy was also on my agenda. In a series of meetings that took place over two days at the Palais des Nations, the UN's home in Geneva, I had some productive discussions with health ministers and officials from a number of countries.

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Vice-Minister da Silva (Brazil)

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Secretary of Health Dr. K. Chandramouli (India)

I met first with Myanmar's newly appointed Minister for Health Dr. Pe Thet Khin and his delegation. Myanmar eliminated leprosy as a public health problem in 2003 and is focused on sustaining leprosy control activities and enhancing efforts to prevent disability. In 2009, it detected around 3,000 new cases of the disease and has a new case detection rate of 5.6 per 100,000 population. The minister told me there are a number of leprosy "hotspots," including some in urban areas, and said they are investigating the causes.

Brazil is the only country where the prevalence of leprosy has yet to fall below 1 case per 10,000 population. In my meeting with Vice-Minister of Health Surveillance Dr. Jarbas Barbosa da Silva, he was keen to highlight his ministry's commitment to addressing this. "I am confident we can achieve elimination around 2015," he said. With these words, we can now look forward to the day when every country will have achieved this public health milestone.

On the subject of human rights, Vice Minister da Silva said that Brazil had made a lot of progress. Former President Lula da Silva launched an initiative in 2006 under which 6,000 people who were forcibly segregated in colony hospitals are receiving state support. "This is a very important commitment on the part of the Brazilian government to support people affected by leprosy and to fight against stigma and discrimination," the vice minister said.

In my discussions with Dr. Enrique T. Ona, secretary of health of the Philippines, he talked of providing incentives to people affected by leprosy for their social rehabilitation. In particular, he felt it was important to focus on their children and ensure they are educated and involved in society. "I am looking to conduct a survey of children and give them support for a college education," he told me.

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Meeting with Health Minister Mphande of Malawi

My next meeting was with Nepal's new Health and Population Minister S.B. Basnet. Nepal achieved the elimination goal in 2010, yet still faces many challenges - one being to sustain this achievement. The minister told me he comes from a remote village, so is well aware of the problems his country faces. "But we cherish the dream of eradicating leprosy, and your goodwill and support will help us to achieve this dream."

After India and Brazil, Indonesia records the most number of new cases of leprosy each year. And for the past decade, the number of new cases has remained more or less constant. When I met Indonesia's Director General of Disease Control and Environmental Health, Professor Dr. Tjandra Yoga Aditama, he told me that one way that Indonesia is endeavoring to tackle this problem is through a tie up with a national alliance of the heads of provinces and districts. The idea is to strengthen leprosy control activities by involving people outside health circles as well.

They told me that leprosy foot care is being integrated with diabetic foot care.

From Sri Lanka, Secretary of Health Dr. Ravindra Ruberu and his delegation told me that a number of leprosy hotspots had been identified at the district level and that active surveillance is being carried out. Commenting that diabetes is a huge problem in Sri Lanka, they told me that foot care for leprosy is being integrated with diabetic foot care.

Next I met with Professor David K. Mphande, the health minister of Malawi, a country I will be traveling to this year. "The leprosy program needs support to move out to the remotest parts of the country to see if leprosy is there. We need to train more people so they know how to diagnose and treat leprosy," he told me. "Many people think that leprosy is completely gone. Your visit will remind them that it hasn't."

India currently has a number of states in which the position of state leprosy officer lies vacant. Given the caseload of the disease in India, I raised my concerns with India's Secretary of Health and Family Welfare Dr. K. Chandramouli. I also proposed holding a meeting of state leprosy officers of endemic states similar to one held in Goa some years ago. The meeting would focus on states such as Orissa, Chhattisgarh and Bihar, where there are still significant pockets of leprosy, and discuss what action was needed.

In addition to these meetings with country representatives, I also held separate talks with WHO regional directors Dr. Luis Sambo (Africa), Dr. Samlee Plianbangchang (Southeast Asia), Dr. Shin-young Soo (Western Pacfic), Dr Hussein Abdel-Razzak Al Gezairy (Eastern Mediterranean), and Dr. Mirta Roses (the Americas).

I had one other important item of business. On May 18, I crossed into France to visit the headquarters of the World Medical Association. There I met Dr. Wonchat Subhachaturas, president, Dr. Jose Luiz Gomes do Amaral, president-elect, and Dr. Otmar Kloiber, secretary general. The WMA is the global federation of national medical associations that represents millions of physicians worldwide. I wanted to discuss the possibility of having the WMA endorse the 2012 Global Appeal to end stigma and discrimination against people affected by leprosy.

Doctors have a key role in clearing up the public's fears and misunderstandings about the disease, and the association's endorsement would carry great weight. The meeting went well and we reached an informal agreement to launch the 7th Global Appeal in Brazil, the home country of President-elect Dr. Gomes do Amaral, next January.

Last but not least, a special word of thanks to the WHO's Linda Aimé-McDonald. Because of her invaluable assistance and organizational skills, my busy schedule of appointments ran like clockwork.