Global interruption of transmission by 2020

Leprosy Mailing List – March 13th, 2012 

Ref.:    << Global interruption of transmission by 2020 >> (?)
From: D. Soutar, London, UK

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Dear Salvatore,

In London on 30^th January, 2012 a major meeting on Neglected Tropical Diseases took place in London.   WHO took the opportunity of this meeting to launch a new document entitled:

Accelerating Work to Overcome the Global Impact of Neglected Tropical Diseases: A Roadmap for Implementation.  The link here is to the full version of the document but I would draw your readers’ attention to the paragraph on Leprosy/Hansen’s disease which is one of the diseases listed in the Roadmap as being targeted for“Global Elimination by 2020”.

http://www.unitingtocombatntds.org/downloads/partners/who_ntd_roadmap_2012.pdf

<< 5.3 Leprosy (Hansen disease)

Of the 122 countries considered endemic for leprosy, 119 have eliminated the disease as a public-health problem (defined as achieving a prevalence of less than 1 case/10 000 population).

The 213 000 cases known to remain are confined mostly to 17 countries reporting more than 1000 cases annually. This number reflects the more than 90% reduction in the number

of cases detected since 1985, mainly as a result of timely case-finding and multidrug therapy. Transmission continues in limited geographical areas of several countries that were

previously highly endemic. Vigorous case-finding and treatment would lead to global interruption of transmission by 2020, and reduce grade 2 disabilities in newly detected cases to

below 1/million population at global level. The development of methods to increase specificity of diagnosis, notably for paucibacillary leprosy, will enhance the elimination strategy. >>

In launching the Roadmap for Implementation WHO DG Margaret Chan herself expressed confidence that “almost all of these diseases can be eliminated or controlled by the end of this decade.”  Leprosy of course is one of the NTDs the Roadmap indicates is targeted for “Global Elimination by 2020”.  This is still based on the definition of elimination as less than one per 10,000 population and is the global target which was already achieved and announced as long ago as 2001.

It was interesting that yet again in such a high level forum people were returning to the thorny question of ‘control or elimination’.  Indeed, at least three of the key speakers on the panels posed the caveat of needing to be very clear about whether we are talking about ‘control’ or ‘elimination’.  Professor Christopher Whitty, for example, the UK Government’s Chief Scientific Adviser and Director of Research and Evidence, warned against falling in to the trap of ‘over-promising’ outcomes which might not in reality be attainable.  He stressed that as many diseases got closer to being eliminated, they required even more effort to cross the final hurdle.

With best regards

Doug

Douglas Soutar
General Secretary
International Federation of Anti-Leprosy Associations
Tel: 44 (0) 207 602 69 25 – Fax:  44 (0) 207 371 16 21 – Website: www.ilep.org.uk
E-mail: doug.soutar(at)ilep.org.uk