WHO updates its fact sheet on Leprosy (8 April 2016)

The World Health Organization (WHO) has updated its fact sheet on leprosy.

Key Messages:

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus.

M. leprae multiplies slowly and the incubation period of the disease is about 5 years. Symptoms can take as long as 20 years to appear.

The disease mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes.

Although not highly infectious, leprosy 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.

Leprosy is curable with multidrug therapy (MDT), and treatment provided in the early stages averts disability.

Elimination of leprosy as public health problem (with a prevalence less than 1 case per 10 000 persons) was achieved globally in the year 2000.

The prevalence rate of the disease has dropped by 99%: from 21.1 per 10 000 in 1983 to persons to 0.24 per 10 000 in 2014.

13 countries accounted for 95% of all cases in 2013, with India contributing 62% of it.

The age-old stigma associated with the disease remains an obstacle to self-reporting and early treatment.

Global Leprosy Strategy 2016-2020:

It is based around three core pillars:

“Pillar I: Strengthen government ownership, coordination and partnership
Key activities of Pillar I include:

Ensuring political commitment and adequate resources for leprosy programmes.
Contributing to universal health coverage with a special focus on children, women and underserved populations including migrants and displaced people.
Promoting partnerships with state and non-state actors and promote intersectoral collaboration and partnerships at the international level and within countries.
Facilitating and conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities.
Strengthening surveillance and health information systems for programme monitoring and evaluation (including geographical information systems).

Pillar II: Stop leprosy and its complications

Key activities of Pillar II include:

Strengthening patient and community awareness of leprosy.
Promoting early case detection through active case-finding (such as campaigns) in areas of higher endemicity and contact management.
Ensuring prompt start of and adherence to treatment, including working towards improved treatment regimens.
Improving prevention and management of disabilities.
Strengthening surveillance for antimicrobial resistance including laboratory network.
Promoting innovative approaches for training, referrals and sustaining expertise in leprosy, such as e-health.
Promoting interventions for the prevention of infection and disease.

Pillar III: Stop discrimination and promote inclusion

Key activities of Pillar III include:

Promoting societal inclusion by addressing all forms of discrimination and stigma.
Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services.
Involving communities in action for improvement of leprosy services.
Promoting coalition-building among persons affected by leprosy and encouraging the integration of these coalitions and or their members with other community-based organizations.
Promoting access to social and financial support services, for example to facilitate income generation, for persons affected by leprosy and their families.
Supporting community-based rehabilitation for people with leprosy-related disabilities.
Working towards abolishing discriminatory laws and promoting policies facilitating inclusion of persons affected by leprosy.

Targets of the strategy

The targets of the new global strategy to be met by 2020 are:

Zero disabilities among new paediatric patients.
A grade-2 disability rate of less than 1 per 1 million people.
Zero countries with legislation allowing discrimination on basis of leprosy.“