Praises and criticisms about the so called leprosy “elimination” Policy

Leprosy Mailing List, March 12^th, 2009

 

Ref.:    Praises and criticisms about the so called leprosy “elimination” Policy

From:  Ganapati R., Mumbai, India

---

 

 

Dear Dr Noto,

 

I appreciate the critical manner in which Dr Christopher Bendick (LML, March 7^th,2009)has examined the claims about the “so called elimination” . Coming from a person who is “neither a leprologist nor an epidemiologist”, the questions he has raised are most thought provoking.

 

In this context I would like to bring to the knowledge of the readers two documents which appeared as LML earlier:-

 

1.

Government of India – WHO Indian Council of Medical Research (ICMR) Workshop on‘Monitoring and evaluation of leprosy control in the post-elimination era’ at the National Institute of Epidemiology (ICMR) Chennai on  5-6 November 2007.

Regarding the terminology of elimination the recommendation was as follows :- “…………..A stage has now come to remove the term ‘leprosy elimination’ from the programme dictionary. It is likely to create adverse impact on patient care and management and also research and funding……….. The focus should be now on sustaining leprosy control and quality care for leprosy patients and provision of referral services".

 

2.

Ganapati R and Pai VV, (2005) “”Has the Term ‘Elimination’ Outlived its Utility ?”, International Journal of Leprosy and other Mycobacterial Diseases, volume 73, No. 3 page 229.  (This article appeared in a slightly modified form as LML)  Relevant excerpts are quoted :

     “……..Has not the jargon “Elimination” of leprosy outlived its utility? Though it is rather late, should we not devise a more patient- friendly term for “Elimination” that truly reflects the sincere attempt at the eradication of all ills afflicting the persons who have contracted specially the progressive forms of the disease?”

 

Elimination was a term devised by WHO to promote the concept of  “bacteriological cure” after “Fixed Duration MDT”. The reduction in prevalence rates over the years to very low levels has been facilitated by the usage of this term.

 

Now, we have to address issues in the post elimination era and follow the recommendation quoted by WHO and ICMR and avoid using the term “leprosy elimination” as far as possible.

 

The pertinent points raised by Dr Bendick by way of criticism need an answer from experts.      

 

Dr R Ganapati

Director Emeritus

Bombay Leprosy Project