(LML) Unblocking the flow of funds for leprosy work

Leprosy Mailing List – January 20,  2019

Ref.:    (LML) Unblocking the flow of funds for leprosy work

From:  Joel Almeida, London and Mumbai

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Dear Pieter,

One of the great and the good in the leprosy world recently reached out to me, expressing interest in the need for a more reliable description of the true magnitude of leprosy.

I am sharing my response below:

"Getting this right will open the blockages in funding that have hampered leprosy work since the year 2000. Once funding becomes aligned with the true size of the burden of leprosy, the situation will be transformed. Getting this right is the first step, like opening the tap on a fire hydrant when needing to fight a fire.

The first part of this first step is finding seed funding to enable sample surveys in leprosy-endemic countries. Certainly, India and Brazil. These surveys will establish both the prevalence of disability and the weight of disability attributable to leprosy.

Once that is done, everything else will follow more easily. That's because the IHME (Institute for Health Metrics and Evaluation) will start describing the GBD (global burden of disease) for leprosy in an informed and reliable way. The decline in funding will be reversed. This is what happened with TB (tuberculosis) in the 1990s. Christopher Murray, now head of the IHME, wrote about TB for the World Bank. I have previously worked with Chris on TB and leprosy calculations. IHME is being fed ignorance about leprosy instead of reliable information.

At the moment people are trying to fight the fire of this infectious disease with thimbles instead of a fire hydrant. Worse, we are claiming partial victory on the basis of reducing the number of thimbles in use (how many people are currently receiving MDT). It is a recipe for continuing decline in funding, which invites a resurgence of leprosy. Such resurgence is reliably being reported from specific hot spots in India, already.

If you can find some funding for these sample surveys, it will be seed funding that can unleash an avalanche of further funding from a wide variety of sources. At the moment the entire national leprosy programme of India is running on about USD 6.6 million per year, according to public statements. That is smaller than the annual budget of many small non-governmental organisations. 

A relatively small amount of seed funding is required for this work. From this seed will the tree of funding grow, yielding not merely funds but also a measurable impact on the incidence rate of new infection and new disability in leprosy.

Then actions and results will start to match intentions and promises."

Best,

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