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WHO Goodwill Ambassador's Newsletter For The Elimination Of Leprosy

REPORT: Stepping on the Accelerator

India looks to generate increased momentum against leprosy.

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“Nothing for us, without us”: persons affected by leprosy were well represented.

A three-day National Leprosy Conference was held in New Delhi from December 5 to review India’s efforts against the disease and how to make further progress.

Organized by the Ministry of Health and Family Welfare, the meeting took as its theme “Accelerating toward a leprosy-free India through innovative approaches” and drew over 300 participants from India and overseas.

India eliminated leprosy as a public health problem at the end of 2005, but in the decade that followed, the annual number of new cases stagnated while new cases with Grade 2 disability increased. Concerned that this indicated a significant number of hidden cases in the community and continued transmission of the disease, the ministry has introduced or is planning a number of initiatives to address the situation.

As highlighted at the conference, these included: the implementation of leprosy case detection campaigns (LCDCs) in high endemic districts; administration of rifampicin as chemoprophylaxis to the contacts of cases identified in LCDC districts to cut down on transmission; Sparsh leprosy awareness campaigns to reduce stigma and discrimination; use of Accredited Social Health Activists (ASHAs) to conduct active surveillance of suspected cases at the grassroots level; introduction of a mathematical modeling tool that will assist in choosing the best available, most cost-effective interventions; creation of a web-based training portal for doctors and health workers; mainstreaming of leprosy colonies; and strengthening surveillance of drug resistance in leprosy.

PUTTING PEOPLE FIRST

Promising in his opening remarks that this would be a conference with a difference, one in which persons affected by leprosy would have a vital role, Dr. Anil Kumar, Deputy Director General (Leprosy) at India’s health ministry, was true to his word. The first session, “Nothing for us, without us,” heard directly from persons affected, who delivered some important messages: “The fear of leprosy is in the mind,” said Jayashree PK, a successful businessperson and vice chair of Lepra in India. “Overcome the fear, and leprosy is defeated.”

During the conference, different states reported on what steps they have taken against leprosy. In Maharashtra, which has the third highest number of cases in the country, surveillance has been increased in villages where no leprosy cases were reported in order to detect hidden cases. This approach is now to be replicated all over India.

In Gujarat, meanwhile, persons affected by leprosy are followed up even after they have been released from treatment to make sure they do not develop further disabilities. Furthermore, the state’s vision is not just to cure leprosy but to mainstream persons affected through reconstructive surgery and rehabilitation programs.

“The fear of leprosy is in the mind. Overcome the fear, and leprosy is defeated.”

Showing that efforts against leprosy need to be wide ranging to be effective, there were sessions on the role of public health specialists, dermatologists and civil society. There was also a session on resource mobilization that highlighted the lack of donors and posed the question: Do we know how much money is needed to eradicate leprosy?

Contributions from international partners included presentations by Novartis Foundation’s Zahira Ganhi on why interrupting transmission is the key to eradicating leprosy; Dr. Wim Van Brakel (Netherlands Leprosy Relief) on innovations in assessing and reducing stigma; Dr. David Blok (Erasmus MC University) on mathematical modeling of leprosy; and Prof. Jan Hendrik Richardus (Erasmus MC University) on preventive post-exposure chemoprophylaxis.

At the close, the conference issued a call for renewed commitment against leprosy and greater collaboration in order to make optimum use of the resources available. “It may take time for India to eradicate leprosy because of the disease’s long incubation period,” said Dr. Kumar. “But we will make it happen.”