This is a collection of articles archived for the excellence of their content.
The disease, in brief
How it spreads
While the mode of transmission of leprosy is not known, the most widely held belief is that the disease was transmitted by contact between those with leprosy and healthy persons. More recently, the possibility of transmission by the respiratory route is gaining ground. There are also other possibilities such as transmission through insects which cannot be completely ruled out. Although leprosy affects both sexes, in most parts of the world males are affected more frequently than females, often in the ratio of 2:1, according to WHO’s Global Leprosy Report.
World Leprosy Day is observed on the last Sunday of January since 1954. Dr. Singh says that “to effectively combat stigma, a multi-sectoral approach is needed. Health authorities need to reach out to and include leprosy-affected persons and communities in their programming. Laws or regulations that sanction or abet discrimination against persons suffering from leprosy should be repealed. A concert of voices should be mobilised to counter harmful social attitudes. Non-governmental and civil society organisations should be included in campaigns to challenge leprosy-related stigma, and to address discrimination against affected persons and their family members.”
SC: 21st century India can not shun patients
Centre told to respond in eight weeks to a call to repeal 119 laws that discriminate against leprosy patients
Twenty-first century society cannot justify shunning persons affected by leprosy or keeping them hidden in homes and away from the mainstream, the Supreme Court declared in an order on Monday.
The court asked the Centre to respond in eight weeks to a call to repeal 119 Central and State laws in practice since the 1950s that discriminate against leprosy patients, stigmatise and isolate them despite the fact that modern medicine completely cures the disease.
A bench led by Chief Justice Dipak Misra, acting on a PIL filed by Vidhi Centre for Legal Policy, found that these statutory laws continue to recognise superstitions that leprosy is “infectious and has something to do with genetics”.
The court has asked the government to explain the continued existence of these laws, which, in a way, deny the truth that modern medicine cures leprosy. The petition has urged the court to intervene and pave the way for recognising the fundamental right to equality, dignity and equal opportunity of persons affected by leprosy.
“There are 119 laws that discriminate against persons affected by leprosy in broadly the following five ways: (i) cause stigmatisation and indignity to persons affected by leprosy, (ii) isolate/segregate persons affected by leprosy, (iii) deny them access to public services, (iv) impose disqualifications on them under personal laws, or (v) bar them from occupying or standing for public posts or office,” Vidhi, represented by senior advocate Raju Ramachandran, said.
These laws rob persons affected by leprosy by denying them equal treatment under personal laws, in matters of employment and appointment or election to public office, as well as access to and free movement in public places, it said.
“This unequal treatment irrationally treats persons affected by leprosy as a separate class... the impugned provisions stigmatise and isolate persons affected by leprosy, even though with the latest medical advancements, leprosy is rendered non-infectious after the very first dose of Multi-Drug Therapy (MDT), the World Health Organisation-recommended treatment regime for leprosy,” the petition said.
Some of the discriminatory provisions are part of laws named in the petition, which include the Coimbatore City Municipal Corporation Act, 1981, Puducherry Municipalities Act, 1973 Tamil Nadu District Municipalities Act, 1920, Delhi Municipal Corporation Act, 1957, Chennai Municipal Corporation Act, 1919, Kerala Khadi and Village Industries Board Act of 1957, Andhra Pradesh Public Libraries Act of 1969, which bans membership to persons affected by leprosy.
Steps by WHO
2016-2020: Global Leprosy Strategy
In 2016, WHO launched the Global Leprosy Strategy 2016–2020: Accelerating towards a leprosy-free world, with the aim of reinvigorating efforts to control leprosy and avert disabilities, especially among children still affected by the disease in endemic countries.
India, which is among the endemic countries, has been advised to include strategic interventions in national plans to meet the new targets, such as screening all close contacts of persons affected by leprosy; promoting a shorter and uniform treatment regimen, and incorporating specific interventions against stigmatisation and discrimination.
2012-18: 2,500 new cases in Mumbai
362 Cases Reported In Mumbai Last Year
For months, Suheil watched a skin patch grow bigger and brighter above his right elbow. The 24-year-old manager of a youth hostel in Mumbai didn’t lose sleep over the painless condition till last July, when his co-worker pointed out it could be leprosy. Panic-stricken, he rushed to a skin doctor, who referred him to NGO Bombay Leprosy Project’s clinic. His fears were confirmed.
Suheil is among 362 people to be detected with leprosy in Mumbai between April and December last year. More worryingly, India accounts for more than half of the two lakh-odd leprosy cases reported across the world every year.
In the last six years, Mumbai alone has recorded nearly 2,500 new cases, and since elimination (which doesn’t mean eradication), over 10,000. Worryingly, cases are not restricted to slum pockets, and have been detected in mainstream colonies, and as Suheil’s case shows, the disease affects all socioeconomic strata, not just the poor.
One-third of the new detections of leprosy is among migrants — a source of disease hard to contain. What has made it challenging is that owing to a lack of awareness, detection in the early stages is difficult.
Suheil contracted paucibacillary, or the milder form of leprosy, an infectious disease India eliminated in 2005. Nobody in his family or at his workplace suffered from leprosy to the best of his knowledge. He is on a six-month-treatment course now, but always anxious about what would happen if his employers found out.
And that’s not even the most worrying part. Out of the 362 cases in 2018-19, 63% were multibacillary, meaning the person had more than five patches, indicative of the disease’s advanced stage. Another sign of missed or late detection is deformities — 11% of the cases had some degree of deformity at the time of diagnosis. Worryingly, 12% of the freshly infected were children.
As the country gears up to observe World Leprosy Day on January 30, activists fear that if the disease’s transmission is not stopped, the last mile from elimination to eradication could be exasperatingly long or simply unattainable. India got the elimination tag in 2005 after its prevalence rate fell to less than 1/10,000 people; this means the disease ceased to be a public health problem. The status, however, derailed efforts to wipe out leprosy at all levels since it fell off the priority list, activists say.
2015: Cases in India
India’s fight against leprosy, being eliminated globally as a public health issue in 2000— is far from over. The World Health Organization (WHO) asked South-East Asian countries, including India which accounted for 60% per cent of such cases worldwide in 2015, to focus on preventing disabilities in children.
According to WHO, leprosy affected 2,12,000 people globally in 2015. India alone reported 1,27,326 new cases, accounting for 60% of new cases globally. The other high-burden countries were Brazil and Indonesia. Of the new cases, 8.9% were children and 6.7% presented with visible deformities. The remaining 10,286 new cases (5%) were reported by 92 countries. Thirty countries reported zero new cases.
India is among the 22 countries considered as having a “high burden for leprosy” along with high transmission by WHO. “Despite being eliminated globally as a public health problem in 2000, leprosy continues to mar the lives of individuals, and impacts families and communities. Though present numbers are a fraction of what was reported a decade ago, they are unacceptable, as an effective treatment for leprosy — multidrug therapy, or MDT — has been available since the 1980s and can fully cure leprosy,” says Dr. Poonam Khetrapal Singh, WHO Regional Director for South-East Asia.
The number of new cases indicates the degree of continued transmission of infection. Global statistics show that 1,99,992 (94%) of new cases were reported from 14 countries reporting more than 1,000 new cases each. Only 6% of new cases were reported from the rest of the world.
New Delhi : The prevalence rate of leprosy in the country has come down from 0. 69 per 10,000 population in 2014-15 to 0. 45 in 2021-22, Union minister of state for health Bharati Pravin Pawar said. Further, the annual new case detection rate per 1,00,000 population has come down from 9. 73 in 2014-15 to 5. 52 in 2021-22, Pawar said at an event to observe National Anti-Leprosy Day here. The theme of this year was “let us fight leprosy and make leprosy a history”.
“India is making progress and new leprosy cases are declining year after year. With the whole of government, whole of society support, synergy and cooperation, we can achieve the target of ‘Leprosy Mukt Bharat’ by 2027, three years ahead of the SDG (Sustainable Development Goal),” said Union minister for health Mansukh Mandaviya. Reiterating Mahatma Gandhi’s enduring concern for people affected with leprosy, he noted the concern and commitment to treat leprosy has its origin in our history. AGENCIES