Consultancy Corner: Achieving real-time eradication of leprosy

Also known as Hansen’s disease, it is a persistent infection that affects the skin and the marginal nerves. Despite considerable efforts of National Leprosy Eradication Program (NLEP), India is still home to 60 per cent of the global burden of leprosy, according to data recorded by the World Health Organisation (WHO). While it is only a mildly contagious condition, Leprosy spreads through nasal and upper respiratory tract discharge. This condition mostly hits the lower socio-economic strata residing in overcrowded slums with poor hygiene and sanitation. The common myth that leads to widespread stigma and discrimination against patients suffering from leprosy is that it spreads through skin contact, which, however, is incorrect. Lack of adequate awareness and late detection of early symptoms of leprosy, delayed diagnosis and initiation of treatment are reasons why India suffers more from leprosy burden compared to other countries across the globe.

Social stigma against those afflicted with leprosy is equally responsible for late detection and treatment as the constant fear of discrimination prevents patients from reaching out to appropriate treatment at the right time. This results in the infection progressing to serious forms affecting the skin, eyes and nerves thereby causing serious deformities and disabilities. Although it is completely curable if detected at early stages, a majority of the patients fail to get access to treatment due to prevalent stigma and are often left homeless, being abandoned by their own family members. This is why celebration of Anti-Leprosy Day, observed on January 30 every year, is essentially important for India as it aims to spread public awareness on the need to tackle this infection by overcoming the barriers of negligence and shame associated with it. While 137, 685 new cases were reported in the country in the year 2007, 2016 saw 135, 485 new leprosy cases and the figures clearly did not show much difference, which was alarming. This is in spite of the fact that the condition is highly under-reported in India due to reduced voluntary or self-reporting marking the fear of stigma.

Another point of concern that needs immediate attention is the exceeding number of children suffering from the condition in the country. Leprosy deeply affects the quality of life of children suffering from the condition. It not only disrupts their childhood and academics but also hinders future prospect, both financially and socially. The Supreme Court had passed a handful of judgments in favour of those suffering from leprosy in the last year. However, these are not adequate and several Indian states continue to deny employment benefits and privileges to these patients.

Although patients may get carried away or misguided to opt for alternative forms of treatment for leprosy, one must know that no alternative treatment can cure them of the condition. These therapies can only provide temporary relief from certain symptoms. The multi-drug therapy that includes antibiotics to fight the leprosy causing bacteria alone can provide complete and permanent cure by killing the bacteria. MDT has excellent cure rates and can provide total cure if the condition is detected early. It is necessary that the patients realise that allopathy treatment is the only way to manage the condition, which otherwise may lead to a miserable state of life.

India may not be completely free of leprosy, but new cases have considerably increased due to campaigns such as National Leprosy Elimination Program. This being said, care providers should be more proactive and ensure that the treatment reaches patients before they reach out for treatment. Steps should be taken to train the patients and their family members about the causes, symptoms and treatment of the condition so that they can overcome the myths and stigma related to leprosy and take necessary actions towards better quality of life. Another possible strategy would be to train medical professionals and care providers to have a high level of clinical suspicion and detect cases earlier in its course. This will certainly reduce the burden of the disease and both the number of new cases as well as the numbers progressing to severe disease will reduce. A multipronged approach with early detection, rehabilitation of patients and tackling the problem of stigma can help the Indian government move a step ahead towards achieving a leprosy-free country in the years to come.