Leprosy Mailing List – April 15, 2021
Ref.: (LML) Death anniversary Pater Damiaan
From: Joel Almeida, London and Mumbai
Dear Pieter and colleagues,
15 April is the death anniversary of Jozef De Veuster, widely known as Pater Damiaan or St. Damien. His efforts to serve people experiencing HD (leprosy) have inspired many, including Mahatma Gandhi, the Damien Foundation, and many others who follow his practical example of respecting the inherent dignity of every human being regardless of geographic origin, social status, or health status. In the 1880s none of the treatments could compare in anti-microbial efficacy with the sulfones, streptomycin, isoniazid, or subsequently discovered drugs that have well proven efficacy against HD bacilli. He contracted HD, developed nodular lepromatous HD, and died before reaching the age of 50.
In those days some organisations from the northern European region were behaving in ways that did not inspire Mahatma Gandhi, in that they sought to subordinate the people of endemic countries in the process of promoting whatever they perceived as being beneficial to their own organisations. Fortunately the world is now awake to the disadvantages of such conduct. There is growing recognition that people of endemic countries need to be allowed sufficient elbow room to succeed in beating HD, using highly effective methods. Currently, that seems to involve a combination of:
Integrated skin camps, with experienced clinicians in person or by telemedicine, for all conditions (not exclusively HD);
MDT (or even more potent anti-microbial drug combinations) prolonged beyond 12 months and until smear negativity;
Mass multi-drug administration, using a combination of bactericidal drugs, given as a single dose at intervals of less than a year.
A decline in new HD cases of over 85% within 2 years is demonstrably achievable with this approach. It originated in the Asia Pacific region and was sponsored by the WHO and the Sasakawa Health Foundation. It is the world's most effective intervention against HD. This is the surest and most rapid known route to success. Endemic countries need not be pressed to regress, rather than progress, by using single drugs instead of multi-drugs for prophylaxis or treatment. Multi-drugs have the advantage of preventing selection of drug resistant mutants, which is a contrast to single drug use.
A list of the CEOs of major global corporations reveals a disproportionate representation of talent from endemic countries. This suggests that getting financial backing to top talent in endemic countries will be one of the most effective ways of improving outcomes and impact in HD. Just as the CEOs from endemic countries strengthen the capability of major global corporations, top young talent in endemic countries can strengthen the capability of colleagues across the world. Then there will be less need to protect endemic countries against harmful interventions and more opportunity for endemic countries to succeed at a rapid pace.
We can achieve victory over HD, millions of children and others will be freed from the threat of HD, and all who have experienced HD will be treated with the respect that is due to every human being. But first it seems helpful to enable rather than subordinate or disable the best young talent in endemic countries. Fortunately this is the direction in which the world is moving.
Joel Almeida
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
--You received this message because you are subscribed to the Google Groups "Leprosy Mailing List" group.
To unsubscribe from this group and stop receiving emails from it, send an email to leprosymailinglist+unsubscribe@googlegroups.com.
To view this discussion on the web, visit https://groups.google.com/d/msgid/leprosymailinglist/2beef7fc-bfb2-4ebb-8c3f-816136c79cddn%40googlegroups.com.
No comments:
Post a Comment