(LML) Voluntary Organizations

Leprosy Mailing List – March 7,  2016

 

Ref.:  (LML) Voluntary Organizations

 

From:  Joel Almeida, Mumbai and London

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Dear Pieter,

 

Voluntary organizations have long been at the forefront of innovation for better health outcomes. This is important now.

 

We have largely eliminated leprosy services and the world has prematurely forgotten leprosy. Meanwhile, the incidence rate of new cases with visible deformity has been increasing in India (40% increase between 2008/9 and 2014/5). This more robustly indicates the underlying trend in the incidence rate of leprosy than changes in the annual new case detection rate. Since the former automatically standardizes for delay in detection and accompanying self-healing.

 

How can we help transform health outcomes?

 

1) Emphasize the 40% increase in the incidence rate of new leprosy cases with visible deformity since 2008/9, in India. That will help restore funding for leprosy services and research. 

 

2) Measure and report the number of persons with visible deformity 2 years after the start of MDT. That will help focus our attention on regular monitoring of nerve function and prompt anti-inflammatory treatment when necessary. 

 

3) Protect polar lepromatous patients against re-infection: for their own sake and for the sake of others. That requires recognition of polar lepromatous patients at diagnosis. Otherwise all our attention to contacts of new patients could prove futile.  

 

Voluntary organizations led the transformation of TB services during the 1980s, after premature self-congratulation had largely eliminated TB services.  Governments eventually learnt from the best practices in voluntary projects, and scaled them up. Now voluntary organizations can transform the scenario in leprosy, by demonstrating best practices that protect the limbs and eyes of populations at risk. That's what matters to ordinary people today.  It's no comfort to them that, for decades, we have mistakenly predicted and promised freedom from leprosy.  Instead of freeing people from leprosy, we have merely withdrawn the skilled, mobile leprosy workers who could help save their limbs and eyes from permanent damage.

 

Now voluntary organizations can show the way forward.

 

 

Regards,

 

Joel Almeida

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LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << editorlml@gmail.com

 

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