WHO organizes 3-day programme managers' meeting on control and elimination of leprosy in the Region in Islamabad

Dr Ni’ma Abid, Country Head WHO Pakistan, in his address welcomed the participants of the workshop to Pakistan and thanked the Government of Pakistan for hosting this meeting and for the support and facilities they provided. He also thanked the Global Leprosy Programme for technically supporting the meeting and also extended appreciation towards The Nippon Foundation and Sasakawa Memorial Health Foundation for their continuous support to leprosy efforts in the Eastern Mediterranean Region.

While giving the background information he referred to the International Leprosy Summit—Overcoming the Remaining Challenges, that took place in Bangkok, Thailand, 24-26 July 2013. He added that during the Summit, Bangkok Declaration was endorsed and signed by The Ministers of Health from the 18 countries with highest leprosy. In this Declaration, The Ministers reaffirmed their commitments towards leprosy and urged all interested parties to accord higher priority for leprosy and allocate more resources in the coming years with the aim to achieve the target of reducing the occurrence of new cases with visible deformity (grade 2 disability), to less than one case per million population by the year 2020.

While highlighting the objectives of the meeting, Dr Abid said that one of the objectives of our meeting is to monitor the implementation of the Global Enhanced Strategy for elimination of Leprosy 2011-2015. In this respect, WHO looks forward to hear from the participants updates on the implementation of the Strategy in countries of the Region, both by the National Programme Managers and partners who support the National Programmes in some areas.

“It is pertinent to mention here that the meeting will allocate a special session on the new Strategy that will start in 2016 and we look forward to your valuable inputs. Also, a practical session is included in the form of a visit to a leprosy clinic in Rawalpindi, similar to the visit we had in the last meeting, held in Cairo in 2012,” Dr Ni’ma Abid shared. 

Towards the end of his address, Dr Abid said that he would like to convey thanks to our experts who are participating and who will surely have great input to the technical content of the meeting, and our partners who have greatly supported leprosy elimination efforts in a number of countries especially areas in emergency situations or difficult to reach geographic areas. “In the end, I wish you a successful meeting and look forward to the outcome of your valuable contributions and discussions,”, Dr Abid concluded.

The session commenced with the presentations of the participants for the technical session. The first presentation was made by Dr H. Ziady (WHO) on the regional updates of leprosy. He informed that in Eastern Mediterranean Region the high burden countries are Sudan and South Sudan while Pakistan is among the countries that have controlled the disease with moderate burden.

His presentation was followed by Dr S. Barua presentation which focused on the Global scenario of this disease. He informed that 80% burden of this disease is shared by 03 countries in the world namely India, Brazil and Indonesia. But because of availability of effective medications worldwide the disease is decreasing drastically. Keeping in view the progress WHO in close collaboration with its partners now in intend to eliminate the debilitating disease and has developed a global strategy (2011-2015). Elimination of leprosy is defined as a prevalence rate of less than 1 case per 10 000 persons. The target was achieved on time and the widespread use of Multi Drug Therapy reduced the disease burden dramatically.

Key facts

• Leprosy is a chronic disease caused by a bacillus, Mycobacterium leprae.
• Official figures show that almost 182 000 people, mainly in Asia and Africa, were affected at the beginning of 2012, with approximately 219 000 new cases reported during 2011.
• M. leprae multiplies very slowly and the incubation period of the disease is about five years. Symptoms can take as long as 20 years to appear.
• Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.
• Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes.
• Early diagnosis and treatment with multidrug therapy (MDT) remain the key elements in eliminating the disease as a public health concern
• Over the past 20 years, more than 14 million leprosy patients have been cured, about 4 million since 2000.
• The prevalence rate of the disease has dropped by 90% – from 21.1 per 10 000 inhabitants to less than 1 per 10 000 inhabitants in 2000.
• Dramatic decrease in the global disease burden: from 5.2 million in 1985 to 805 000 in 1995 to 753 000 at the end of 1999 to 181 941 cases at the end of 2011.
• Leprosy has been eliminated from 119 countries out of 122 countries where the disease was considered as a public health problem in 1985. 

The WHO Strategy for leprosy elimination contains the following:

• ensuring accessible and uninterrupted MDT services available to all patients through flexible and patient-friendly drug delivery systems;
• ensuring the sustainability of MDT services by integrating leprosy services into the general health services and building the ability of general health workers to treat leprosy;
• encouraging self-reporting and early treatment by promoting community awareness and changing the image of leprosy;
• monitoring the performance of MDT services, the quality of patients’ care and the progress being made towards elimination through national disease surveillance systems.