“The last mile is the hardest.” “On a journey of 100 miles, 99 miles is only half way.” Readers of this newsletter will be familiar with these aphorisms as they apply to efforts to achieve a world without leprosy. They are on our lips again as we peruse the annual Global leprosy update from the WHO. While progress is being made, case-detection activities are being scaled up and the gap between hidden cases and detected cases has reduced, more is required.
“With the current tools, the decline will continue—though slowly,” said Dr. Erwin Cooreman, team leader of WHO’s Global Leprosy Programme, on a recent visit to Tokyo. “We need new tools if we want to make a big dent in leprosy.”
To accelerate progress, effective tools for diagnosing infection with M. leprae (better still, for diagnosing infection that will lead to disease) and preventive treatments or vaccines are necessary. This will require substantial investment in basic research. Without new tools, cases of leprosy will continue to occur well into the next century at the current rate of decline.
But given that leprosy is a slow-moving bacterial infection, research will take time before meaningful conclusions can be reached regarding the effectiveness of new interventions. “That is the nature of leprosy. We cannot change the behavior the bacillus,” said Dr. Cooreman. The sooner we introduce new tools, however, the quicker we can make strides toward completing that 100-mile journey.
Regular readers of this newsletter will also know that this publication normally appears every two months. Please note that the current issue, #87 (October 2017), follows Issue #86 (June 2017). We thank you for your forbearance.