Info Service on Health Issues (Sept18/02)
19 September 2018
Third World Network
Increased focus on newer endemic diseases contributes to leprosy increase
friends and colleagues,
increased attention by health authorities on relatively new endemic
diseases such as malaria, HIV and TB may have contributed to the increase
of new leprosy cases in the world.
was stated by Yohei Sasakawa, chairman of the Nippon Foundation and
the WHO Goodwill Ambassador for leprosy elimination.
an interview with IPS, he said that although free multidrug therapy
(MDT) has been provided to leprosy sufferers, there are many patients
with HIV, malaria and TB, and these diseases get more attention from
health ministries than leprosy.
is not a medical disease, it is a social problem … For a long time,
history has shown that people with leprosy were highly discriminated
… and this still exists quite strongly amongst almost every population,’
to him, achieving Zero Leprosy is not difficult; ‘we need an exhaustive
dissemination of the message that it is possible to treat the disease
and that medication is free at health centres. … this disease is not
difficult to diagnose, it is easy to identify’.
and discrimination are ancient and deeply rooted … to end this stigma
we need to have the participation of all of us working together to
change this situation,’ he concluded.
following story is reproduced with permission from IPS and South-North
Development Monitor (SUNS) #8735, 3 August 2018.
increases as world gives attention to newer endemic diseases
Muchanga, IPS, Maputo, Mozambique, 30 July 2018
In the first six months of this year, the southern African nation
of Mozambique has already registered 300 more cases of leprosy, some
951 cases, than it registered for the whole of 2017.
The country, which had previously eliminated the chronic disease in
2008, is receiving funding from the Nippon Foundation - a non-profit
philanthropic organisation from Japan that is active in many countries
across the globe in eliminating leprosy - to provide free multi-drug
therapy (MDT) to leprosy sufferers.
Leprosy is curable, and if treated early enough disabilities related
to the disease can be averted. But treatment can take between six
to 12 months.
The chairman of the Nippon Foundation and the World Health Organisation
(WHO) Goodwill Ambassador for leprosy elimination, Yohei Sasakawa,
recently visited the country to assess Mozambique's progress in identifying
and treating leprosy.
He told IPS that the increased attention by health authorities on
relatively new endemic diseases such as malaria, HIV and tuberculosis
(TB) may have contributed to the increase of new leprosy cases in
This is despite the fact that treatment for the disease remains free.
The W HO has provided MDT for free since 1995 thanks to initial funding
from the Nippon Foundation.
Sasakawa said while the WHO has indicated that a prevalence rate of
one leprosy case per 10,000 inhabitants indicates elimination of the
disease, "this indicator is simply a milestone. Eradication has
not yet been achieved, so we must continue to work towards eradication
Excerpts of the interview follow:
Inter Press Service (IPS): There has been a massive decline in the
prevalence of leprosy following the global implementation of MDT in
the 1980s by the WHO. However, there are still over 200,000 new leprosy
cases recorded every year. And we have seen the emergence of multi-drug
resistant leprosy in recent years. How has this affected the prevalence
Yohei Sasakawa (YS): Both in the past and now, MDT is supplied by
our foundation and distributed free of charge. Although the medication
continues to be distributed free of charge, there are many patients
with HIV, malaria and TB, and these diseases get more attention from
ministries of health than leprosy.
This fact increases new cases of leprosy. There was a complication
caused by multi-drug resistant leprosy, which also contributes to
the increase in the number of patients, but it is a very small number,
a much lower percentage.
IPS: How can Zero Leprosy be achieved?
YS: It starts from talking about the disease by using a social approach,
because leprosy is a social problem. So the leaders of a country,
teachers in schools etc., must work to spread the knowledge that leprosy
is a curable disease.
It is possible to cure with the correct treatment, which starts with
the diagnosis of the skin. (Initial symptoms are patches of skin that
are paler than normal.) If this message is spread exhaustively, for
sure leprosy will be zeroed.
IPS: Do you find it difficult to reach the level of Zero Leprosy?
YS: Achieving Zero Leprosy is not such a difficult process.
As I have said, we just need an exhaustive dissemination of the message
that it is possible to treat the disease and that the medication is
free at health centres. This is the only way that Zero Leprosy will
be reached because this disease is not so difficult to diagnose, it
is easy to identify.
IPS: Treatment of leprosy costs nothing. But we are seeing a shift
towards complacency about the disease among government policy makers,
and hence an increase in the prevalence of the disease in some areas.
This is unfortunate. Why is this the case? And how do we address this?
YS: Leprosy is not a medical disease, it is a social problem. This
disease has no symptoms like pain, and this fact alone makes some
people choose not to go to hospital when they come across spots on
their skin etc. But with time, deformation takes place and then the
person feels ashamed to go to hospital because of discrimination ...
For a long time, history has shown that people with leprosy were highly
And this discrimination still exists quite strongly amongst almost
every population... I had the opportunity to see in Nampula (northern
Mozambique) that those recovered from leprosy work as volunteers in
the search for other people with leprosy in need of treatment. I think
this is very good and would be even better if it were spread throughout
IPS: What concrete actions is your foundation carrying out, especially
in Africa, to eliminate leprosy?
YS: Over the last 40 years the foundation has been working to provide
the necessary assistance to people with leprosy through the WHO, and
we will continue providing this assistance.
In Africa, specifically in countries with cases of leprosy, I try
to talk to the top leader, the president. I explain the situation
to them in order for them to take action. I think in talking to presidents
it makes it easier for a ministry of health to get a bigger budget
and carry out its activities.
The number of people with leprosy is much lower than those with HIV,
malaria and TB. So it is very difficult for the government to allocate
a larger amount to the ministry of health to tackle this disease,
and this is not prioritised. So I go to these countries and ask the
government to increase funding to the ministry of health to combat
IPS: Your foundation has given support to many countries towards eliminating
leprosy. What is the feedback from these countries and what can be
taken as model or case for success?
YS: The feedback is very positive. We are experiencing a significant
reduction in cases of leprosy with countries declaring themselves
free from leprosy, although there are new cases. India is a great
example, the country has the greatest number of leprosy sufferers
in the world - about 70 percent of the world's cases of leprosy are
in India - and the work that has been developed there is positive.
However, one concrete case of success was in Indonesia where I met
a girl who developed the disease at 18 and was cut off from her family.
I had the opportunity to have a meal with this girl, and that gesture
demystified that leprosy was a cursed disease.
IPS: Your foundation managed to lobby the United Nations to pass a
resolution for the "elimination of discrimination against persons
affected by leprosy and their family." How do you measure the
result of this lobbying today with regards to the commitment and actions
from member states?
YS: It is true that we have been able to mobilise countries and pass
this resolution, but what happens is that this rule contains its principle
and guideline but has no penalty. Some countries have included this
rule in their policies but unfortunately there are only a few countries
that have done that.
Recently, a leading rapporteur was elected by the Directorate of Human
Rights (in the UN Human Rights Office of the High Commissioner), and
will have to visit countries and see why they are not complying with
the UN recommendation of 2010.
IPS: There still remains significant stigma attached to the disease.
And the stigma placed upon people with leprosy has been considered
one of the greatest social injustices. In some parts of Africa people
with leprosy are still separated from society, when research and science
proves there is no need to. How do we overcome this?
YS: In fact there is discrimination against leprosy sufferers and
this is difficult to remove from people. Stigma and discrimination
are ancient and deeply rooted. So it is not only with my efforts that
we are going to end this stigma, we need to have the participation
of all of us working together to change this situation.