Leprosy is a disease that has fascinated many people and seen them devote decades of their lives to tackling it. One of the veterans of the fight for a leprosy-free world is Dr. S.K. Noordeen, the former director of the WHO's action program to eliminate leprosy and now chairman of the Leprosy Elimination Alliance. Speaking on the sidelines of the recent International Leprosy Summit in Thailand, he underlined the significance of the Bangkok Declaration that was endorsed by health ministers and their representatives.
"It is important to make a noise," he said. "People are paying attention. Program managers, NGOs and others can use the declaration. It's a political commitment. They can say to ministers, 'You agreed to it.'"
But he also sounded a note of caution: "Political commitment has a shelf life. It only lasts a few years." Making the most of the opportunity is therefore crucial.
The challenge, he said, is to persuade health ministers to devote limited resources to a relatively small problem. "You want them to focus on high-endemic areas, but as politicians they may want to spread the resources equally, or where they can find political support." Countries must also have the infrastructure in place if things are to happen, he said. "Without the right infrastructure, resources won't reach where they need to go."
Dr. Noordeen has a fund of tales about calling on ministers to ask them to place a higher priority on leprosy. The health minister of one African country told him, "You are the third person I have seen this morning: first malaria, then TB, now leprosy. What am I supposed to do?" When Dr. Noordeen mentioned that a neighboring country had already eliminated leprosy as a public health problem, the minister was suddenly interested.
Then there is the story about the shock experienced by Indira Gandhi, India's late prime minister, when a visiting Middle Eastern diplomat asked her how she could talk about India's development when the streets of Delhi were full of people suffering from leprosy. From her official vehicle, the prime minister never saw these sights. The next day she called the health minister to ask, 'What are you doing about leprosy?' The situation changed overnight. "Sometimes politicians have to be embarrassed into action," Dr. Noordeen said.
On this occasion, we believe, ministers have endorsed the Bangkok Declaration, not out of embarrassment, but because they know it is the right thing to do. The last mile is in sight, and there is a job to finish.