Speech of Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia Region, Global National Leprosy Programme Managers Meeting, 23-25 November 2015, New Delhi, India
23-25 November 2015, New Delhi, India
Mr Tatsuya Tanami, Executive Director, The Nippon Foundation,
Dr Jan van Berkel, President, International Federation of Anti-leprosy Associations,
Mr Sunil Sharma, Joint Secretary, Ministry of Health and Family Welfare, Government of India,
Representatives from United Nations agencies, colleagues from WHO headquarters, regional and country offices,
Ladies and gentlemen,
It is a great pleasure for me to welcome you to Delhi and to this global meeting of managers of national leprosy control programmes. I see that we have programme managers from the regions of Africa, America, Eastern Mediterranean, Western Pacific and, of course, South East Asia. Further, we are fortunate that we have the rare privilege of having so many experts of leprosy gathered in one room.
As early as 2000 the elimination goal of leprosy as a public health problem at the global level was achieved. Yet in 2014, two hundred fifteen thousand six hundred and fifty six (215,656) cases of leprosy worldwide were reported. Why? We should ask ourselves that question. With the galaxy of experts and programme managers gathered in this room, we must not miss this opportunity to shape a meaningful and effective strategy to change this situation. Ten years from now, we should be in a position to say that leprosy has been eliminated from every district or similar administrative units of all countries currently endemic to leprosy.
The Global Leprosy Programme, in close consultation and collaboration with many partners and through an iterative process, has drafted a strategy for the next five years to accelerate reducing the leprosy burden. Since this meeting brings together all stakeholders in leprosy control, this is your opportunity to further improve this strategy before its official launch next year. It is my hope that by the end of this three-day meeting, we will have a realistic and an effective leprosy control strategy for the next five years which everyone agrees to.
But it is not enough to have a strategy. We have to implement such a strategy and implement it with vigour. If you look at the global epidemiology of leprosy, 96% of leprosy cases are limited to just 15 countries. And because 72% of leprosy cases are reported from the South-East Asia Region alone, I have put leprosy on the highest agenda in my region; leprosy is one of the flagship priorities I identified so that it gets adequate resources and support for the programme to intensify efforts to improve this situation. Other flagship areas – such as universal health coverage, aiming to provide access to a defined package of health services at an affordable cost, or addressing antimicrobial resistance – also have links with leprosy control. Synergies can thus be defined with other programmes or cutting across health system components. The Sustainable Development Goals, as adopted by the United Nations General Assembly last September, also provide an anchor to link leprosy with the wider development agenda of ending poverty, reducing inequalities, building happy communities and promoting partnerships. I believe it is important to grasp these opportunities when elaborating the five-year strategy to control leprosy.
Ladies and Gentlemen, it is clear that even in the endemic countries leprosy is not uniformly distributed and the high prevalence is usually confined to defined narrow geographic regions or in certain endemic pockets often referred to as “hotspots.” The challenge for the leprosy programme is to identify these pockets and to aggressively search, treat and follow up leprosy cases till such hotspots are cleared. We know this epidemiological aspect of leprosy, we have the tools and means to detect and treat leprosy, but we are not succeeding. This meeting must think of the reasons why we are not succeeding and come up with measures that will change this situation.
I may mention that to identify correctly the hotspots for leprosy, the national programme has to have a good surveillance and reporting system in place. You need to review your information system for reporting and tracking leprosy cases so that where weaknesses exist, they are addressed appropriately. Intensified case finding coupled with effective and completed MDT treatment still remain the core tenets of leprosy control. Therefore, I urge all countries still endemic to leprosy to strengthen their systems for early case detection and complete treatment so that the burden of leprosy is reduced and visible deformity prevented.
Leprosy is not like any other disease. Age old stigma around the disease makes it a challenge to find cases early enough and to complete treatment. And those who develop visible deformities, rehabilitation and re-integration into their own communities become a major challenge. But we must spare no efforts. Let us not forget that a leprosy patient deserves to be treated with dignity and respect, and not just as a mere statistic. Therefore, any strategy that you develop must include the social aspect of leprosy for a holistic approach to its control and prevention.
Research is a relatively neglected aspect of most disease control programmes. I would like you, the experts in this room, to think about research needs to strengthen control programme. Apart from research on drug resistance, which is an emerging problem, we also need to identify important implementation research agenda so that knowledge gained is translated into action thus spurring further search for new knowledge to improve our future strategies to control and prevent leprosy.
With these few remarks, I would like to wish you fruitful discussions and deliberations. I have kept leprosy prominent on my own agenda. I also assure you of my commitment to push forward whatever agreed strategy you present me.
Once again, let me welcome you to the great city of Delhi. The weather is perfect now and I do hope that, in spite of your busy schedule, you will find some time to discover some of the cultural delights of our capital city.