August 10, 2017
ILEP Member Lepra, a UK-based international charity, reported this week that up to 93% of leprosy cases in the world are undetected. Despite the declared ‘elimination’ of the disease worldwide in 2005, Lepra’s ‘Hidden leprosy figures report’ suggests that, far from having disappeared, the disease has spread. Lepra believes that more than 3 million people are living undiagnosed with the disease around the world today.
In 1991, the target for eliminating leprosy was defined by the World Health Organization as a prevalence of less than one case per 10,000 people. At the time, resources were allocated to research and community screening programmes. However, once the target was met in 2005, political interest, resources and economic incentives to actively find new cases disappeared, which dramatically affected the number of new cases reported annually.
Danger of complacency
“Leprosy is making a comeback in many countries around the world, where the expertise and infrastructure dedicated to detecting and treating the disease has been dismantled,” said Paul Watson, Head of Programmes and Advocacy at Lepra. “As a result, approximately 50% of all new leprosy cases were missed during the period 2000 to 2015 and, if you therefore take into account the backlog of accumulated undiagnosed cases since the turn of the millennium, today we are detecting and assisting only an estimated 7% of those people believed to be currently infected with the disease.” He continued:
“Leprosy is treatable and, if detected early, disability can be prevented. Governments around the world need to refocus attention on leprosy so that it may be made a ‘disease of no consequence’, as an important step towards it eventual eradication everywhere.”
Since ‘elimination’ was proclaimed, visible disabilities among people newly diagnosed with leprosy have increased by 13%. This indicates a delay in leprosy detection and, indirectly, its continuous transmission in the community.
Raising these issues this week, Lepra referred to the case of Mohammad Mubarak, a 12-year-old boy in India (pictured above). Leprosy has destroyed the nerves and muscles in his ankle, leaving him with “foot drop” – a condition which means he is no longer able to lift his foot. This disability could have been prevented if Mohammad had been diagnosed earlier. However, for months his doctors believed he had polio.
Dr Sonia Sethi, a Lepra doctor who is now treating Mohammad says: “There are gaps in services. Doctors are seeing 250-300 patients a day and they don’t have the time or specialist knowledge to recognise leprosy.”
Mohammad is now receiving the correct treatment and he also wears specialist footwear to help lift his foot and strengthen his ankle muscles. He will be assessed in six months to see if he will require surgery to further improve his mobility.
For Mohammad, and countless others like him, earlier detection of leprosy would make a massive difference to future quality of life. By focusing more resources on leprosy detection and care, it can become – to quote Lepra’s Paul Watson – a ‘disease of no consequence’ for these people and can eventually be eliminated.
ILEP’s vision is a world free from leprosy. The Triple Zero Campaign contributes to this goal by focusing on three key areas: Transmission, Disabilities and Discrimination. By working with our Members towards bringing each of these interconnected areas down to Zero, we will make substantial progress towards achieving our vision.
(Photos: Idris Ahmed)