Friday, June 4, 2010

Clofazimine availability and distribution

Leprosy Mailing List – May 10th, 2010

Ref.: Clofazimine availability and distribution.
From: E. Post, Amsterdam , The Netherlands



Dear all,

I have been following this discussion for many years now, and with growing irritation. As we all know loose clofazimine is available from the WHO when ordered by the national leprosy control programme manager, or whatever person responsible for leprosy control at the national level.

It is more than clear (for at least for about 7 years clear for me!) that the distribution system as it is organised by WHO is not functioning and not reaching the field and above all not reaching the patients who need it. In effect, differences of opinion between high placed burocrats in the leprosy world leaves the leprosy patient with recurrent ENL in the cold. Often it is because WHO does not take orders from the field seriously and only a fraction of what was ordered is then delivered. From my own experience in Indonesia I know that for some provinces a meticulous registration system for ENL reactions was in place, realistic orders were made by the national unit to WHO, but then in the end this was not honoured by WHO. Very frustrating. Other experiences are that one or the other ILEP member is ordering clofazimine, and has given up hope for supplies through government-WHO.

It is commendable that ILEP organisations fill this gap. But... at the same time I find it very disappointing that WHO has in all those years not been able to organise this distribution system appropriately. ENL can have very disabling effects. With the current global policy being geared towards prevention of disabilities, I think it should be a matter of honour for WHO to get clofazimine distribution well organised within a short time, without too many expensive consultations.

I would challenge the global leprosy programme to react constructively on this issue on the Noto list, and not keep silent again. For the good order: this mail was copied to those responsible.


Many regards to all,


Erik Post

Royal Tropical Institute, Amsterdam

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