In Depth - Fight Against Leprosy

• 05 Feb 2019

Every year, India observes 30th January as Anti-Leprosy Day. Worldwide, the same day is observed on the last Sunday of January, every year. Anti-Leprosy Day aims to spread awareness about the impact of discrimination and social stigma on the efforts to stop the spread of disease. This year’s theme for Anti-Leprosy Day is 'Ending Discrimination, Stigma, and Prejudice’.

Global Scenario

• The countries with the highest number of new Leprosy cases are India, Brazil and Indonesia followed by some of the African nations.
• In 2017, there were 14 countries, reporting more than 1,000 new cases of Leprosy. These were Bangladesh, Brazil, Democratic Republic of Congo, Ethiopia, India, Indonesia, Madagascar, Mozambique, Myanmar, Nepal, Nigeria, Philippines, Sri Lanka, and Tanzania.
• Over 16 million leprosy patients have been treated over the past 20 years across the globe.

Indian Stats

• According to WHO, India accounts for more than half of leprosy cases, detected worldwide. In 2017, India accounted for the 60% of new cases, detected in the year (1.26 lakh cases out of 2.10 lakh cases).
• As of March 2018, Bihar has the highest number of cases (14388 cases) followed by Uttar Pradesh (12,583), Maharashtra (9836), West Bengal (9175) and Chhattisgarh (6499).
• In terms of prevalence, as of March 2018, the Union Territory of Dadra & Nagar Haveli topped the count with its 202 cases, representing 4.85 cases per 1 lakh population.
• Among the states, Chhattisgarh has the highest prevalence (2.25 per lakh population), followed by Odisha (1.38), Bihar (1.18) and Jharkhand (1.05).
• As per the recent report by the National Leprosy Elimination Program (NLEP), of the total new cases detected in India, Children accounted for about 8.7% of total Leprosy cases.

Leprosy

Also known as Hansen’s Disease, Leprosy is a chronic, progressive bacterial infection. It is caused by a bacterium called Mycobacterium Leprae, which is an acid-fast rod-shaped bacillus. It is a disease that leaves a terrifying image in its wake of mutilation, rejection, and exclusion from society.

• Oldest Disease
  • Leprosy is one of the oldest diseases in recorded history, afflicting humanity since time immemorial.
  • A written account of Leprosy date as far back as 600 B.C.
  • It was well recognized in the oldest civilizations of China, Egypt and India thousands of years ago.
  • Genetic evidence supports the existence of Leprosy infections in hundred-thousand-year-old remains.
• Areas of Infection: Skin, Peripheral nerves, Upper respiratory tract and Lining of the nose.
• Mode of Transmission: Mainly by breathing airborne droplets from the affected individuals. It can be contacted at any age.
• Symptoms
  • Red patches on the skin.
  • Skin Lesion
  • Numbness in arms, hands, and legs.
  • Ulcers on the soles of feet.
  • Muscle Weakness and excessive weight loss.
• Long Incubation Period: It usually takes about 3-5 years for symptoms to appear after coming into contact with Leprosy causing bacteria. The long incubation period makes it difficult for doctors to determine when and where the person got infected.
• If not treated on time, Leprosy can lead to significant disability, disfigurement, permanent nerve damage in arms and legs and even loss of sensation in the body.
• Cure: Leprosy is curable with the combination of drugs known as Multi-Drug Therapy (MDT).

Challenges

• Detection of Leprosy is the biggest hurdle in eradicating Leprosy.
• NLEP finds that factors such as lack of awareness, fear, stigma, and discrimination as the most powerful barriers in eradicating the disease.

Steps Taken by WHO

• Free distribution of MDT to all endemic countries since 1995.
• Global Leprosy Strategy 2016-2020: Aims to reinvigorate efforts to control Leprosy and avert disabilities, especially among children, still affected by the disease in endemic countries. The strategy also calls for renewed political commitment, enhanced coordination between partners, the inclusion of persons affected by Leprosy in Program Management and highlights the importance of Research, Improved Data Collection, and Analysis.

Steps Taken by India

• In 2016, the draconian colonial era’s Lepers Act was repealed.
• In 2017, SPARSH Leprosy Awareness Campaign was launched to promote awareness and address the issues of stigma and discrimination.
• The measures included in the campaign like contact tracing, examination, treatment, and chemoprophylaxis are expected to bring down the number of Leprosy cases.
• The special emphasis on women, children and those with disabilities are expected to flush out more hidden cases.
• In addition to continuing to administer MDT to patients, new preventive approaches such as Chemoprophylaxis and immunoprophylaxis are being considered to break the chain of transmission and reach zero disease status.
• In 2019, Lok Sabha passed a bill seeking to remove Leprosy as a ground for divorce.
• In commemoration of the 150th birth anniversary of Mahatma Gandhi on 2nd October 2019, the NLEP has prepared the comprehensive plan to reduce the grade to disability to less than one case per million people by October 2019.

Leprosy Patients often suffer from mental illness like depression and anxiety due to the discrimination and the stigma, that they are subjected to, by society. A new environment, in which patients will not hesitate to come forward for diagnosis and treatment at any health facility must be created ensuring no discrimination and promoting inclusion.