LEPROSY

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Context

In a historic achievement, Jordan has become the first country to eliminate leprosy, receiving official verification from the World Health Organisation (WHO).

Leprosy

Aspect	Details
Definition	Leprosy (Hansen's disease) is a chronic infectious disease caused by the bacteria Mycobacterium leprae or Mycobacterium lepromatosis. It primarily affects the skin, nerves, respiratory tract, and eyes.
Transmission	Spread through prolonged close contact with an infected person . Transmission occurs via respiratory droplets (sneezing, coughing).
Types of Leprosy	Tuberculoid: Milder, few skin lesions, less contagious   Lepromatous: More severe, multiple skin lesions, highly contagious
Geographical Distribution	High Burden Countries: India, Brazil, Indonesia  Common in tropical and subtropical regions
Efforts for Elimination	WHO’s Leprosy Elimination Program: Aimed at reducing cases WHO Leprosy Strategy (2021-2030): Focuses on zero leprosy-related disabilities in children, early detection, and reduction of social stigma. International Leprosy Association (ILA): Advocacy and research
Leprosy in India	India accounts for more than 50% of global leprosy cases  National Leprosy Eradication Program (NLEP) aimed at early diagnosis and treatment

Leprosy in India

Leprosy was declared eliminated in India one-and-a-half decades ago, but it has re-emerged in several states with increasing intensity. India leads the world in new leprosy cases, followed by Brazil and Indonesia. According to the WHO, India accounts for over half of the global total of new cases, with more than 200,000 new cases detected globally every year. Between 2016 and 2018, India reported 60% of the world’s new leprosy cases. In 2017 alone, 13,485 new cases were detected, meaning one person is diagnosed with leprosy every four minutes in India.

Reasons for the Recurrence of Leprosy

After leprosy was declared eliminated in 2005, new cases continued to be reported. Major changes in the National Leprosy Elimination Programme (NLEP) and Global Leprosy Programme helped detect new and child leprosy cases, many of which were diagnosed late.

Following the declaration, leprosy was merged into the National Health Mission, diluting the focus on targeted leprosy eradication. Pockets of high endemicity, where transmission persisted, were identified.

A survey by the Indian Council of Medical Research (ICMR) revealed many hidden cases in the community, attributed to low voluntary reporting due to lack of awareness and societal stigma.

Government Apathy

The decision to declare leprosy eliminated in 2005 was premature, leading to complacency among policymakers and the public. The shift from a mission-based approach to a public health program reduced the intensity of ground-level efforts.

Elimination, defined by WHO as reducing prevalence to less than one case per 10,000 people, was confused with eradication, which means complete absence of the disease. This confusion led to insufficient post-elimination policies.

After elimination was declared, new cases dropped by 75% between 2004 and 2007. However, resources and funding for leprosy programs decreased as the government’s focus shifted to combating HIV/AIDS. This diversion of resources harmed efforts to address leprosy.

Government Response

In 2017, the National Health Policy (NHP) set a new goal for eliminating leprosy by 2018. 

Jordan 

Aspect	Details
Official Name	Hashemite Kingdom of Jordan
Capital	Amman
Location	Middle East, bordered by Saudi Arabia, Iraq, Syria, Israel, and the West Bank.
Geographical Features	Dead Sea (lowest point on Earth)  Jordan River Predominantly arid desert plateau
Official Language	Arabic
Currency	Jordanian Dinar (JOD)
Government Type	Constitutional Monarchy
Main Exports	Phosphates, fertilizers, garments, potash, chemicals, vegetables
Imports	Oil, machinery, equipment, foodstuffs, manufactured goods
Foreign Relations	Strong ties with the USA, Saudi Arabia, and European Union Known for maintaining peace agreements with Israel Hosts a large number of Palestinian and Syrian refugees

Way Forward

To achieve real eradication of leprosy, a robust and clear strategy is essential, with a well-defined implementation plan.

Strengthening the public health system at the ground level, particularly in areas reporting a high number of cases, is critical.

Addressing the stigma and discrimination associated with leprosy is crucial. Awareness campaigns should encourage voluntary reporting and ensure that individuals seek timely treatment.

Sources: 

IndiaToday

PRACTICE QUESTION Q:Leprosy, though declared eliminated in India in 2005, has re-emerged in recent years. Discuss the challenges in combating the disease and suggest measures for its effective eradication. (250 Words)