Create leprosy awareness: SC

The News

  • The Supreme Court directed the government to constitute a separate wing which will be devoted to create and extend public awareness that leprosy is curable and not contagious.

 

Highlights of the SC Direction

  • A three-judge Bench led by Chief Justice of India Dipak Misra ordered All India Radio and Doordarshan to air programmes nationally as well as regionally in the States.
  • The judges said it was the primary duty of the state to erase the stigma against those suffering from leprosy and nudge them back into the mainstream.
  • There had to be social awakening to the fact that leprosy is curable and not contagious, considering the advance made in modern medical science.
  • Afflicted persons could not be exposed to stigma which denuded them of basic human dignity.
  • Earlier, the court had asked the Centre and the States to remove references to leprosy as a disability from 119 laws.
  • It had noted that references to leprosy as a disability amounted to statutory stigma.
  • Stressing the need for awareness campaign right up to the ‘gram panchayat’ level, the Bench said such measures would eventually help in eradicating the disease and ending ‘discrimination’ of sufferers.

 

About Leprosy

  • Leprosy is a chronic infectious disease caused by Mycobacterium leprae.
  • The disease mainly affects the skin, the peripheral nerves, the mucosa of the upper respiratory tract and the eyes.
  • Leprosy is curable and treatment provided in the early stages averts disability.
  • Multidrug therapy, is made available by WHO free of charge to all patients worldwide since 1995, provides a simple yet highly effective cure for all types of leprosy.
  • Control of leprosy has improved significantly as a result of national and subnational campaigns in most endemic countries.
  • Integration of basic leprosy services into general health services has made diagnosis and treatment of the disease more accessible.

 

Leprosy Prevalence in India

  • Status in the States/UTs 34 states and UTs achieved elimination out of 36 States/ UTs.
  • One State (Chhattisgarh) and one U.T. (Dadra & Nagar Haveli) are yet to achieve elimination.
  • Five more states/UTs wherein elimination was achieved earlier, namely Odisha, Bihar, Chandigarh, Goa and Lakshadweep have reported with PR>1/10,000 population, as on 31st March 2017.
  • Prevalence Rate in India as on March 2017:

 

 

International efforts

  • In 2016, WHO has launched a new global strategy – The Global Leprosy Strategy 2016–2020: accelerating towards a leprosy-free world – which aims to reinvigorate leprosy control efforts and avert disabilities, especially among children affected by the disease in endemic countries.
  • This strategy emphasizes the need to sustain expertise and increase the number of skilled leprosy staff, to improve the participation of affected persons in leprosy services and to reduce visible deformities – also called grade-2 disabilities – as well as stigmatization associated with the disease.
  • The strategy also calls for renewed political commitment and enhanced coordination between partners, and highlights the importance of research and improved data collection and analysis.

 

National efforts- Milestones in Leprosy eradication

  • 1955 – National Leprosy Control Programme (NLCP) launched
  • 1983 – National Leprosy Eradication Programme launched
  • 1983 – Introduction of Multidrug therapy (MDT) in Phases
  • 2005 – Elimination of Leprosy at National Level
  • 2012 – Special action plan for 209 high endemic   districts in 16  States/UTs

 

The National Leprosy Eradication Programme(NLEP)

  • It is a centrally sponsored Health Scheme of the Ministry of Health and Family Welfare, Govt. of India.
  • The Programme is headed by the Deputy Director of Health Services (Leprosy) under the administrative control of the Directorate General Health Services Govt. of India.
  • While the NLEP strategies and plans are formulated centrally, the programme is implemented by the States/UTs.
  • The National Leprosy Eradication Programme is being continued with Govt. of India funds from January 2005 onwards.
  • Additional support for the programme is continued to be received from the WHO and ILEP organizations.
  • MDT is to be supplied free of cost as of now by NOVARTIS through WHO.
  • As a result of the hard work and meticulously planned and executed activities, the country 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 the month of December, 2005.
  • As on 31st December 2005, Prevalence Rate recorded in the country was 0.95/10,000 population.

 

Issues that need to be still addressed

  • Problems with leprosy integration:
  • Leprosy cases are noted to be sometimes wrongly diagnosed or missed by the primary health centre (PHC) medical officers.
  • This is mainly because of lack of effective training and varied presentations of the disease.
  • Hence, strengthening referral networks is important to support integrated leprosy control services.
  • Decline in number of leprosy experts:
  • Over the last few years involvement of dermatologists in vertical programme has diminished in India and moreover, dermatologists are also now more focused towards lucrative branches of dermatology.
  • Drug resistance:
  • The emergence of drug resistance is a cause for concern and a threat in post-elimination era.
  • It is important to monitor the emergence of rifampicin-resistant mutants as it is an important bactericidal component in MDT.
  • Stigma:
  • Leprosy is one of the most ancient and dreadful diseases. The stigma associated with the disease is an important hurdle in self-reporting.

 

Way forward

  • Government, non-governmental organizations (NGOs) and private organizations need to work together in a coordinated fashion in the final battle against leprosy.
  • Continued training of medical officers, nurses, physiotherapists, paramedical workers about quality diagnosis and treatment of leprosy is necessary.
  • Empathy rather than sympathy is important in leprosy rehabilitation.
  • Physical rehabilitation includes physiotherapy, occupational therapy and various reconstructive surgeries to improve the function of the hands, feet and eyes.
  • Social and economic rehabilitation is equally important to restore dignity of leprosy patients.
  • Disability prevention and medical rehabilitation (DPMR) services, training in self-care (skin care, wound care and joint care), provision of necessary protective equipment, orthotic appliances, physiotherapy, mobility aid and reconstructive surgery are very crucial in post-elimination era to make the patient self-sufficient and to further reduce the stigma.
  • A new environment free of stigma and fear needs to be created for early diagnosis and treatment of the remaining cases towards a leprosy free world.

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