Leprosy

• 08 Feb 2019

Why in News?

• World Leprosy Day is observed on the last Sunday of January. It seeks to increase public awareness about leprosy and focuses on the target of zero cases of leprosy-related disabilities in children.
• The theme for the 2019 World Leprosy Day is ‘ending discrimination, stigma, and prejudice’.
• In India, it is celebrated on the 30th January chosen as a tribute to the life of Mahatma Gandhi who had a lifelong compassion for people affected by leprosy.

Leprosy

• Leprosy is 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.
• 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.
• 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).

Concerns on the Government's claim on Elimination of Leprosy

• As per official data, 135485 new Leprosy cases were detected during 2016-17 that is one leprosy case was diagnosed every four minutes.
• The underreporting of cases has made the leprosy database unreliable source creating difficulties in the timely treatment.

World Health Organisation’s Global Leprosy Strategy (2016)

• The key interventions as provided in WHO’s Global Leprosy Strategy include:
  • Detecting cases early before visible disabilities occur, with a special focus on children as a way to reduce disabilities and reduce transmission;
  • Targeting detection among higher risk groups through campaigns in highly endemic areas or communities; and
  • Improving health care coverage and access for marginalized populations.
  • Leprosy Endemic countries need to include other specific strategic interventions like:
    • Screening all close contacts of persons affected by leprosy.
    • Promoting a shorter and uniform treatment regimen.
    • Incorporating specific interventions against stigmatization and discrimination.

Steps Taken by India to Eliminate Leprosy

• Govt. of India started the National Leprosy Control Programme in 1955. It was only in 1970s that a definite cure was identified in the form of Multi-Drug Therapy (MDT).
• The 1st Phase of the World Bank supported the National Leprosy Elimination Project started from 1993-94.
• In the year 2001, after the global elimination was achieved, India was among the 14 countries that missed the target of eliminating leprosy. 
• The National Leprosy Eradication Programme that was launched after this, achieved the goal of elimination of leprosy as a public health problem, defined as less than 1 case per 10,000 Population, at the National Level in December 2005.
• In 2016, the draconian colonial era’s Lepers Act was repealed.
• In 2017, the 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.

Conclusion

• In 2018 the Supreme Court directed states and the Central government to roll out awareness programmes about leprosy. The court said campaigns should utilize positive images and stories of those who had been cured.
• India should integrate leprosy care with other areas of healthcare so that the perception of it being a dreadful disease that has to be treated separately disappears.
• WHO strategy document for the year 2016–2020 calls for promoting inter-sectoral collaboration within countries. Associations like Indian Association of Leprologists (IAL), oldest leprosy association of India, should be the official partner of NLEP.
• The dermatologists should be included and assigned an active role in the leprosy programme.
• 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. An inclusive environment, in which patients do not hesitate to come forward for diagnosis and treatment at any health facility must be created.