|Poster for campaign to screen children for leprosy and intestinal parasites in Brazil|
Health ministers and their representatives pledge ongoing commitment.
The Goodwill Ambassador met with health ministers and their representatives at the recent World Health Assembly in Geneva for an update on leprosy and leprosy control activities in their countries.
Keshav Desiraju, Secretary, Ministry of Health and Family Welfare
While many states have shown good progress, we still have something like 125,000 new cases each year. In statistical terms, it is a small number, but in actual numbers it is very big. We are speaking to state governments about this. One problem is that people don't seem to find leprosy work interesting. In some states the post of leprosy officer is not filled. It may be that somebody who is trained to do that job is being used elsewhere because leprosy is not seen as a priority. We regard leprosy as a very important area of our work. It is a priority for us, even if it is not a priority for state governments.
Dr. Nafsiah Mboi, Minister of Health
Although we have eliminated leprosy as a public health problem at the national level, we still have pockets of the disease in 14 out of 34 provinces, such as Aceh and Papua. When we visited Papua last December, we found a community of 332 people with 108 cases of leprosy. Areas such as Papua are more challenging because of the geographical situation, but if we can get local leaders involved and secure their commitment, I believe we can do a lot.
Dr. Jarbas Barbosa, Vice-Minister of Health Surveillance
Many states in Brazil now have a very low prevalence of leprosy, but in some states - the poorest ones - prevalence is still high. We have just completed a leprosy elimination monitoring process for each state. We want to use the data we gathered to secure a strong commitment from the states and municipalities most affected. This year we undertook a unique initiative, in conjunction with neglected tropical diseases, screening around 16 million children, focusing on the poorest municipalities. We plan to do this every year. We are also addressing the human rights issue. Brazil was one of the first countries to provide compensation for people confined in colonies and we are also looking for children who were separated from their parents.
Juvenal Arcanjo Dengo, 1st Secretary, Permanent Mission to Geneva
The leprosy situation is stable but we think we can do more, particularly in the north and center of the country. Leprosy is being featured in schools, where children are being taught how to identify the disease. We believe this will contribute to early diagnosis. One area where we are weak is in social mobilization. We are determined to mobilize more information and to cover more districts and more people. By partnering with NTDs we hope to improve. We are interested in the experiences of other countries in integrating leprosy with NTDs.
Dr. Kesetebirhan Admasu Birhane, Minister of Health
Leprosy has never been out of our top priorities. It is something that we monitor regularly. We have an extensive network of primary care facilities and community extension workers. Eight years ago, we only had 600 primary health centers; today we have 3,000. By the end of this year, this will rise to 3,500. At some of the new health facilities, new health workers do not have the necessarily skills to diagnose leprosy. During their training they are exposed to diseases such as HIV/AIDS, malaria and TB. But leprosy patients are less common and concentrated in a few areas, so the majority of health workers do not see what the early signs of leprosy look like. We need to continue to improve their skills.
Dr. Donan W. Mmbando, Acting Chief Medical Officer, Union Ministry of Health and Social Welfare
We would like to ask you for your continued cooperation because we still have some pockets of leprosy in the country. We are working hard not to be complacent. It is very important to us that we continue to tackle leprosy. We also thank you for your role in realizing the U.N. General Assembly resolution on eliminating discrimination against persons affected by leprosy. This is necessary because of the stigma attached to people with the disease.
Prof. A.F. Ruhal Haque, Minister of Health and Family Welfare
Case numbers have come down, but we have pockets. As you well know, the last mile is always the most difficult. I am an orthopedic surgeon and used to see a lot more leprosy cases earlier in my career. Patients would come with foot drop, but such cases are much rarer these days.Our prime minister attaches special importance to addressing the needs of the poor and instructs us to make them a priority through various programs. I am also pleased to report that Bangladesh abolished a discriminatory leprosy act that dated back to the 19th century.
Dr. Pe Thet Khin, Minister of Health
Since eliminating leprosy as a public health problem, we have become a little complacent. I think we need to apply ourselves harder. Because the number of patients in Myanmar is now quite small, young doctors are not so interested in the disease. I would like to do something to stimulate their interest. For example, one way would be to include leprosy as part of the medical school curriculum.
Dr. Maithripala Sirisena, Minister of Health
Sri Lanka had 30 very difficult years due to terrorist activities. Democracy and human rights were violated by terrorist groups. People's lives, the economy and social development were all impacted. Today, following the war, democracy has been established in the country to the fullest extent. A lot of development is taking place in the north and east, especially in the health and education sectors. The government is concerned to see development occur in an equitable manner.
Dr. Li Mingzhu, Deputy Director-General, Dept. of International Cooperation, National Health and Family Planning Commission
Since the 1950s, the incidence of leprosy has been coming down very quickly, particularly in the first 40 years. Since the 1990s, numbers have remained flat. Most of the problems we face relate to the difficulty of detection. Perhaps people and organizations have become complacent. The government is training doctors and nurses and making efforts to educate the public about leprosy to reduce stigma, but we still face challenges.
Dr. Enrique T. Ona, Secretary of Health
Although we have eliminated leprosy as a public health problem, there are still a number of pockets in the country where cases are present, but not in the context of the very serious deformities we have seen in the past. I would like to utilize dermatologists to help general practitioners identify early cases of leprosy. I would also like to do something for people still living in leprosaria. We have to be more active in helping them to reassimilate into the community. As long as people continue to live in leprosaria, the stigma will always be there.