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No.88 Ambassador’s MESSAGE: ‘Elimination Trauma’

 

I recently gave the keynote address at the National Leprosy Conference that took place in New Delhi from December 5 to 7. Organized by Dr. Anil Kumar, the Deputy Director General (Leprosy) at India’s Ministry of Health and Family Welfare, it was something of a departure from the usual gatherings of specialists thanks to the diversity of the participants.

Beginning with a session for persons affected by leprosy on the theme, “Nothing for us, without us,” it continued with presentations on everything from the grassroots case-finding activities of female community health workers to the work of public health officials at state and district level, and the contributions of doctors, academics and activists.

Under the initiative of Dr. Kumar, the health ministry introduced leprosy case detection campaigns (LCDCs) from 2016. In the first year, more than 30,000 additional new cases were discovered, contributing to an annual total of over 135,000 new cases—a marked increase from the year before.

I have previously used this space to talk about what I call “elimination trauma.” By this I mean that once a country has eliminated leprosy as a public health problem (defined as less than 1 case per 10,000 population), those in charge breathe a sigh of relief. At the same time, they live in fear of case numbers going up again.

Although it should be a noble mission to discover and treat as many new cases as possible, for some years now annual new case numbers in many countries have leveled off. I think this is because health ministries are embarrassed at the thought of once more becoming a country that has not achieved elimination. In 2016, however, India shattered that mindset with its proactive approach.

I have said it before, but an increase in case numbers is not something to be ashamed of; it means that cases are being detected. You have also heard me say: on a journey of 100 miles, 99 miles is only halfway.

India has now set itself the ambitious challenge of achieving zero leprosy by 2030. I would like to see all countries aim for zero leprosy, taking India as their model.

– Yohei Sasakawa, WHO Goodwill Ambassador

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