Leprosy is not a disease of the past

Antoine Delers
28 May 2019
Contrary to what we might think, leprosy does not belong to the past. So how can this terrible disease be completely eradicated?

Leprosy today

Leprosy is an infectious disease caused by a bacillus that slowly multiplies in the infected organism. It primarily affects the poorest and most vulnerable sections of the population. In 1985, approximately 5.4 million people around the world suffered from leprosy. Thankfully, the fight against this disease has yielded impressive results over the last few decades.

Now, around 216,000 new patients are identified every year in countries such as Brazil, India, Indonesia and the Philippines, which represents a 96% drop since 1985. This success is mainly due to intensive control programmes: early detection and treatment with effective medication. The introduction in the 1980s of polychemotherapy (PCT), a therapy which combines two or three different medications, is the most effective way of fighting the pathology.

But the fight is not over. Even though the World Health Organisation (WHO) declared leprosy eradicated in 2000, the disease remains a significant burden for both individuals and society in some regions of the world. If leprosy is no longer considered a major problem, it risks being neglected or forgotten. Despite the decrease in leprosy, the number of new cases per year is not dropping below 200,000, which is a cause for alarm.

Today, leprosy is mainly contracted in poor countries, more specifically in regions with limited access to healthcare. Furthermore, local populations are often not aware of the disease's initial symptoms and put off travelling to consult a doctor. At the same time, due to the reduced occurrence of leprosy, local practitioners see fewer cases of the disease and sometimes have trouble identifying early symptoms. Despite the fact that the WHO no longer considers leprosy to be a real threat to public health, early screening for the disease remains necessary, particularly to avoid its propagation and to increase the cure rate.

If leprosy is no longer considered a major problem, it risks being neglected or forgotten.

The sick: victims of discrimination

In some regions, there is still a lack of knowledge about leprosy, its cause and its symptoms, which does not help the screening process. Colonies of deformed patients, quarantine, exile, contamination, discrimination and shame are still the reality in some parts of the world. Leprosy sufferers experience not only different kinds of deformity, but also discrimination. They are often excluded from their families and from society, and in some parts of the world are forced to live in "leper colonies". "This is a safe place. Outside, we are considered monsters," said one sufferer living in an Egyptian colony.

Leper colonies are safe places. Outside, we are considered monsters.

Nigerians washing their wounds
© Tim Dirven/Action Damien

The new WHO strategy

Due to the success of the treatments, the WHO is no longer seeking to "eliminate leprosy as a public health problem". On the contrary, its Global Leprosy Strategy 2016–2020 has the goal of "accelerating towards a leprosy-free world". It is based on three pillars:

  • strengthen government coordination and partnerships;
  • stop leprosy and its complications;
  • stop discrimination and promote inclusion.

What is Belgium doing?

Action Damien

Action Damien is a Belgian NGO that fights three diseases: leprosy, tuberculosis and leishmaniasis (a less well-known disease caused by parasites). It is active in 16 countries, including India, Bangladesh, Democratic Republic of Congo, Niger, Nigeria and Bolivia. In 2017, Action Damien provided treatment to more than 214,000 people suffering from one of these three diseases. To combat these pathologies, the NGO:

  • provides medical aid to patients (screening, diagnosis, treatment and followup care);
  • combats stigmatization and ignorance by educating and informing local populations;
  • promotes and facilitates active screening;
  • provides technical and financial support for local partners;
  • assists patients after treatment (Care after Cure programme);
  • encourages training and the sharing of experiences;
  • and promotes scientific research.

Institute of Tropical Medicine of Antwerp

The Institute of Tropical Medicine (ITM) in Antwerp contributes to scientific progress in the fields of public health and tropical medicine. Its activities include research into leprosy. ITM researchers are currently leading the PEOPLE project in the Comoros and Madagascar, two countries that continue to have high numbers of leprosy cases. This study deals with leprosy by using different preventive treatment methods for people in contact with leprosy patients, with a view to eradicating the disease in these countries. The Institute works in partnership with Action Damien, the Fondation Raoul Follereau and national leprosy programmes. One of its researchers has helped to improve the Action Damien's active screening by expanding the use of a mobile application called Open Data Kit (ODK). The app allows sufferers to be recorded and endemic areas to be mapped.

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