The World Health Organization defines leprosy elimination as reducing the level of prevalence to below one in 10,000 of the population. Most of the countries that were formerly highly endemic for leprosy have now achieved elimination by this definition, but many of those same countries (most notably India) still have many cases of leprosy. According to the article, many countries stepped down their efforts against leprosy once the elimination target had been reached. In consequence progress against the disease, of which there are still around a quarter of a million new cases every year, has thus suffered.

The article also refers to a new report from WHO’s Southeast Asian Regional Office (SEARO) which puts forward a new strategy for further reducing the disease burden due to leprosy. Most notably, under this strategy, the rate of new cases with grade-2 disabilities among new cases per 100,000 population would be used as a key indicator to monitor progress.

TropIKA.net’s own coverage of World Leprosy Day 2010, which emphasized the role of research, may be accessed here.

Saint Damien won recognition for his ministry to people with leprosy (also known as Hansen’s disease), who had been placed under a government-sanctioned medical quarantine on the island of Molokai in the Kingdom of Hawaii. He eventually contracted and died of the disease in 1889.

Since Saint Damien’s time, much progress has been made against leprosy but many barriers still need to be overcome before the disease is eradicated. Over 200,000 people worldwide are registered with leprosy and some two to three million people are estimated to be permanently disabled as the result of the disease. India has the greatest number of cases, with Brazil second and Burma third. Stigma, even against people who no longer have leprosy, holds back control efforts.

Highlighting the work of Saint Damien may help renew global efforts to fight the disease.

Commenting on the canonisation, President Barrack Obama said Father Damien’s life should stand as an example for how to deal with modern-day diseases - see ABC News report.

Obama’s comments are of interest given that the President, who of course was born in Hawaii, has chosen to increase the funding that the US provides for the control of neglected tropical diseases - see TropIKA.net News.

The announcement was made at the annual meeting of the Clinton Global Initiative in New York - see press release.

The meeting heard that soil transmitted helminths and Chagas disease cause the greatest NTD burden in the Americas, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. More than 230 million people in the region are currently living with these devastating diseases.

Partners involved in the new initiative range from the Brazilian soccer team to pharmaceutical giant GlaxoSmithKline (GSK) and Partners for Philanthropic Change.

GSK has also recently announced that it will provide Brazil with some of its vaccine technology and also fund research in Brazil for a vaccine for dengue fever - see Wall Street Journal.

According to the laws of some Indian states they cannot hold a driving licence, travel by train or stand in local elections. Having leprosy is also grounds for divorce. The employment that people affected by leprosy are allowed to perform is restricted, and the restrictions remain even years after a person has been cured.

An article in the Hindu newspaper calls for the antiquated laws to be changed.

Leif Kirsebom and colleagues say they have now shown that, not M. tb. but a ‘close relative’, can form spores. Apparently their discovery was initially an accidental finding. The research has not yet been published but is expected to appear shortly in the Proceedings of the National Academy of Sciences. It is to be hoped that this new knowledge of the Mycobacteria might ultimately lead to new ways to control TB and other mycobacterial diseases in humans and animals. These include leprosy and Buruli ulcer.

The Korea Times reports the words of Prime Minister Han Seung-soo at a ceremony to mark the Day for Leprosy Patients at Sorok Hospital. Leprosy patients on Sorok Island, says the Times, “have maintained an isolated and repressive life for decades.”

The PM said, “It took so long for the nation’s prime minister to meet people with leprosy. On behalf of the government, I offer deep apologies and condolences to the patients and their families who had unspeakable suffering amid social discrimination and prejudice.” He went on to promise that the government would now take “substantial action” to protect the rights and welfare of people with leprosy.

It is good therefore to see a report of a programme in Allahabad which is making progress in efforts to provide treatment and support for people with the disease. Part of the programme is the provision of reconstructive surgery but very few leprosy patients have taken advantage of this. It is thought that their unwillingness to come forward is a consequence of the widespread stigma against leprosy. The programme is making efforts to improve awareness of the disease. Early diagnosis is seen as another priority. See report in the Times of India.

The article notes that: “While the focus on AIDS accounted for nearly 60 percent of the bank’s projects on communicable diseases from 1997 to 2006, more successful efforts aimed at malaria, tuberculosis and leprosy, among others, got far fewer resources. Malaria, for example, made up 3 percent of the projects, and tuberculosis only 2 percent.” It also quotes William Easterly, an economics professor at New York University, as saying that the evaluation confirmed for him “a fear that many of us have had for some time: that hugely disproportionate attention to AIDS has had a negative effect on aid efforts for all other health problems.”

The evaluation concludes that AIDS projects were often over-ambitious and that many were too complex for the weak or inexperienced bureaucracies carrying them out. The evaluation is available on the World Bank website.

However, Mozambique has progress to report as regards other infectious diseases of poverty. Leprosy is no longer regarded as a public health problem in the country. In 2008, all provinces in Mozambique recorded less than one case of leprosy per 10,000 inhabitants.

Measles vaccination campaigns have led to a dramatic reduction in notified cases, by over 95 per cent in three years. In 2005, the health authorities recorded 12,598 measles cases but in 2008 the figure fell to 278.

From 2007 to 2008 the number of known cases of malaria also fell by 24%. The health ministry attributes this to recent campaigns of of insecticide spraying against mosquitoes, and improvements in malaria diagnosis and treatment. (Malaria of course often does vary greatly from one year to the next.)

The figures were released by Health Minister Ivo Garrido during a meeting of his ministry’s Coordinating Council. They are reported on allAfrica.com.

“Leprosy seems to be going down every year,” says Dr Foday Dafae, who manages the Ministry of Health’s National Leprosy and Tuberculosis Control Programme. However, Antoinette Fergusson of the German Leprosy and Tuberculosis Relief Association, which supports the national programme, said it was important not to forget about the disease. It is still widely regarded in Sierra Leone as being caused by witchcraft and people with leprosy suffer from stigma.

Read the full story here.