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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 305-306
Moving ahead from leprosy elimination to leprosy-free world by 2020


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication22-Jun-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Moving ahead from leprosy elimination to leprosy-free world by 2020. Ann Trop Med Public Health 2017;10:305-6

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Moving ahead from leprosy elimination to leprosy-free world by 2020. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Jun 16];10:305-6. Available from: http://www.atmph.org/text.asp?2017/10/2/305/208708
Over the centuries, leprosy has been associated with fear, prejudice, ostracization by the family and the community, and is one of the leading causes of the deformity or disability attributed to an infectious condition.[1] In-fact, the recent estimates suggest that the incidence and prevalence of the disease were 0.3 and 0.24 cases per 10000 populations respectively in the year 2014.[2] Further, it has been identified that almost 94% of the new cases are reported from 13 nations only, where the rest of the world account for the remaining cases.[2]

Although, the global stakeholders were able to achieve elimination of disease (viz. a prevalence of <1 case/10000 populations) in the year 2000, nevertheless isolation of new cases reflects the presence of a continued transmission of infection, and evidences of high endemicity in some of the regions due to the intense transmission.[2] At the same time, the percentage of new cases with Grade 2 disability and incidence among children have remained constant since 2010, suggesting the failure of the health sector to ensure early disease detection, and even indicating that transmission of the disease is still continuing.[1],[2],[3]

From the control perspective of the disease, it is not highly contagious, completely curable through multi drug therapy (in excess of 16 million people cured in the last two decades), disabilities can be averted with early initiation of treatment, and no evidence of emergence of resistance to the multi-drug therapy, are all encouraging attributes.[1],[2],[3],[4] Overall, the control activities have improved remarkably because of the national and sub-national campaigns in endemic regions and because of the integration of the control measures into the general health services, thereby ensuring that both diagnostic and treatment services are more accessible.[1],[2],[3],[4] Further, because of the constant effort and improved access to therapy, prevalence of disease decreased by 99% between the time-span of 1983 and 2014.[2]

In an attempt to reduce the disease burden, emphasis was given on detection of all cases and the completion of treatment.[1],[3] However, in the global mission towards a leprosy free world, the WHO has set the target to achieve zero disability among new paediatric patients, a grade-2 disability rate of less than one case/million population, and ensure that no nation has a law which allows discrimination on the basis of disease by the year 2020.[2] This can be accomplished by increasing the number of skilled staff, enhancing the involvement of affected persons in disease-related services, augmenting the political commitment, improving coordination between different partners, and giving importance to research and better surveillance and analysis.[1],[2],[3],[4]

Further, under the “Global Leprosy Strategy 2016-2020”, emphasis has been given to the strengthening of the coordination and partnership activities (viz. political commitment, supply of adequate resources, addressing needs of migrant population, facilitating inter-sectoral collaboration, encouraging research activities, improving surveillance, monitoring and evaluation activities); (including geographical information systems); stopping leprosy and its associated complications (like creating awareness about the disease in general population, promoting early case detection through active case-finding, initiating treatment promptly, managing disabilities effectively, strengthening surveillance for antimicrobial resistance, and implementing measures for the prevention of infection); and stopping discrimination and promote inclusion (through empowering the capacity of diseased persons to actively participate in disease related services, involving representatives from community or other community-based organizations, facilitating income generation activities for affected persons and their families, assisting in community-based rehabilitation, and abolishing provisions which promotes discrimination.[1],[2],[3],[4],[5]

To conclude, owing to the sustained efforts from multiple national and international stakeholders, the burden of the disease has reduced extensively. However, in order to move nearer to a leprosy-free world, there is a significant need to empower the people affected by the disease, and augment their involvement in the service delivery.

Acknowledgement

SRS contributed in the conception or design of the work, drafting of the work, approval of the final version of the manuscript, and agreed for all aspects of the work.

PSS contributed in the literature review, revision of the manuscript for important intellectual content, approval of the final version of the manuscript, and agreed for all aspects of the work.

JR contributed in revising the draft, approval of the final version of the manuscript, and agreed for all aspects of the work.

 
   References Top

1.
Chaptini C, Marshman G. Leprosy: a review on elimination, reducing the disease burden, and future research. Lepr Rev 2015;86:307-15.  Back to cited text no. 1
[PUBMED]    
2.
World Health Organization. Leprosy - Fact sheet; 2016.Available from: http://who.int/mediacentre/factsheets/fs101/en/ [Last accessed on 2016 April 11].  Back to cited text no. 2
    
3.
Majumder N. Socio-economic and health status of leprosy affected person: A study in Jharkhand. Indian J Lepr 2015;87:145-54.  Back to cited text no. 3
[PUBMED]    
4.
Abeje T, Negera E, Kebede E, Hailu T, Hassen I, Lema T.Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia. BMC Health Serv Res 2016;16:122.  Back to cited text no. 4
    
5.
Ramos JM, Romero D, Belinchón I. Epidemiology of leprosy in Spain: The role of the international migration. PLoS Negl Trop Dis 2016;10:e0004321.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.208708

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