NEW THIS THURSDAY: GLOBAL LEPROSY UPDATE

Sunday, 1st of September 2013

GLOBAL LEPROSY UPDATE

Editorial note below; full text is at http://www.who.int/wer/2013/wer8835.pdf

Leprosy control has benefitted greatly from the implementation of MDT, which has enabled the disease to be cured and reduced the number of new G2D cases; consequently stigma associated with leprosy and resultant discrimination against those affected have been reduced. There have also been economic benefits, with

reduction of health system costs incurred for disability care, reconstructive surgery and rehabilitation. Nevertheless, surveillance of drug resistance, and research to

develop shorter regimens and preventive agents, need to be continued or initiated in order to sustain the gains achieved and further reduce the disease burden due to

leprosy.

During the year 2012, a global total of 232 857 new leprosy cases were detected, 6231 more cases than in 2011. With emphasis on early case finding as the principal tool available to reach the target set by the enhanced global strategy, it can be expected that reporting of new cases will increase. Among the WHO Regions, this increase is seen mainly in the South-East Asian and African Regions.

The Enhanced Global Strategy for further reducing the disease burden due to leprosy (2011–2015) set as a target the reduction of the G2D rate to one third of that in 2010. The G2D rate was 0.23 per 100 000 population in 2010 and it should have reached 0.17 by the end of 2012, based on extrapolation of the linear trend per 100 000 population. However, with 14 409 new cases including G2D cases detected in 2012, the G2D case rate actually shows an increase to 0.25 per 100 000 population.

WHO developed Guidelines for strengthening participation of persons affected by leprosy in leprosy services5 to promote greater involvement of those affected and reduce stigma in the community. Meaningful involvement of persons affected will help in all components of the leprosy programme, from detecting cases early enough to reducing stigma and promotion of social integration. The participation of the persons affected will also help in operationalization of the enhanced global strategy and in policy formulation.

From the global statistics it is notable that 220 810 (95%) of new leprosy cases were reported from 16 countries and only 5% of new cases from the rest of the world.

While stronger political commitment and mobilization of increased resources are essential for improving the programme implementation, there is also a need to adopt local problem-specific strategies at subnational levels (provinces, districts, municipalities) to address diverse factors influencing the leprosy situation in the 16 high-burden countries. These complementary approaches are both essential at this juncture to achieve further reduction of the disease burden due to leprosy in accordance with the enhanced global strategy2 and recommendations of the WHO Expert Committee onleprosy.6