IRIN Focus on new drive against leprosy

A global alliance that aims to eliminate leprosy as a public health problem from every country by 2005, was officially launched here by the World Health Organisation WHO) on Monday at the start of a three-day conference. The Global Alliance for Leprosy Elimination and its partners aim to detect and cure some 2.5 million to 2.8 million leprosy sufferers in the world by the end of 2005, thereby eliminating the disease, WHO said in a news release. The WHO defines elimination as less than one case per 10,000 persons. “The term ‘elimination’ means bringing the disease burden down to a very low level which will lead to a reduction in the source of infection so that the disease will disappear naturally as it did in many parts of the world,” Dr Maria Neira, director of the WHO’s Department of Communicable Diseases Control, Prevention and Eradication, told delegates at the Third International Conference on Elimination of Leprosy. Leprosy is a public health problem in 24 countries, of which 12 will meet the elimination goal in the year 2000 if strategies are intensified and accelerated. Eight of the 12 are in West Africa: Cameroon, Chad, Cote d’Ivoire, Gabon, The Gambia, Guinea-Bissau, Mali and Sierra Leone. The others are Congo, Ethiopia. Papua New Guinea and Paraguay. WHO said special efforts will be needed to reach elimination in the other 12 countries: Angola, Brazil, Central African Republic, Democratic Republic of Congo, Guinea, India, Indonesia, Madagascar, Mozambique, Myanmar, Nepal and Niger. Leprosy is a curable disease and disability can be avoided if it is treated in the early stages. The current treatment consists of multidrug therapy (MDT), which WHO recommended in 1981 and describes as “safe, effective, economical and easy to administer under field conditions”. According to Neira, the success of the final push against leprosy demands “synchronised implementation of all the core elements as well as some refinement to accommodate local variables”. The core elements include: improving access to leprosy services by enabling all health facilities in endemic districts to diagnose and treat leprosy; ensuring availability of free MDT drugs at health centres through improved logistics. They also include motivating people to seek treatment by creating better community awareness of the early signs and dispelling fear of the disease; ensuring high cure rates through innovative and patient-friendly drug delivery systems, active monitoring and taking timely corrective action. Health ministers and national programme managers from endemic countries welcomed the Global Alliance and committed themselves to implementing the intensified strategy. Over the past 15 years, 10 million leprosy patients have been cured using MDT, the prevalence rate has dropped by 85 percent and the number of countries where leprosy is a public health problem has dropped from 122 to 24, WHO said. “Leprosy elimination means not only bringing an end to a public health problem caused by an infectious disease but also to a socio-economic problem as a consequence of the disease,” Neira said. “Because persons with chronic manifestations of the disease such as disabilities are often unable to work or marry, they become dependent for care and financial support on others, leading to further insecurity, shame, isolation and consequent economic loss,” she added. In addition to WHO, core members of the Alliance include leprosy endemic countries, the Nippon Foundation, the International Federations of Anti-Leprosy Associations (ILEP) and the Novartis Foundation for Sustainable Development, a WHO news release said. The Alliance will also work closely with other non-governmental organisations, the Danish International Development Agency and the World Bank. During the opening speeches at the conference, The Nippon Foundation and the Sasakawa Memorial Health Foundation pledged to contribute US $24 million to WHO to help in the implementation of the Global Alliance’s strategy. Novartis promised medication worth US $30 million over the next six years to cure all the leprosy patients in the world. “We are grateful for the strong support of our partners, both old and new, in the final years of the fight against leprosy,” WHO Director-General, Dr Gro Harlem Brundtland, said in a video message to the conference. “Let us join hands and make a final push to consign a dreaded disease to history.”