Fw: (LML) How to defeat HD even in the COVID-19 era

 

Leprosy Mailing List – April 28,  2020

 

Ref.:  (LML) How to defeat HD even in the COVID-19 era

 

From:  Joel Almeida, London and Mumbai

---

 

 

Dear Pieter and colleagues,

 

The COVID-19 pandemic has highlighted the importance of the reproductive number R0. For too long, we were blind to the importance of this in HD (Hansen's disease). Once the R0 of LLp (polar LL) HD is reduced to below one, HD starts declining and disappears. MB (multibacillary) HD is the best indicator of this epidemiological decline, because other forms of HD can be self-limiting and non-infectious.

 

The rapid decline of MB HD demonstrated in Uele (DR Congo) and Shandong (China) shows us the critical intervention for success. It is prolonged anti-microbial protection for LLp patients. This critical intervention is not being prevented by COVID-19. Rather, we have not always been caring for LLp patients as they require and deserve. 

 

Many traditional buildings have a cornerstone. The whole structure is constructed in relation to that cornerstone. If we reject the cornerstone as worthless, then the whole building can fail. This is what we have been doing in recent decades, as shown by the stagnation in new MB HD patients. Instead, we could be providing prolonged anti-microbial protection to LLp patients and achieving a rapid decline in new MB HD patients, 20%/year leading to near-zero transmission. The evidence has been reviewed in previous contributions here.

 

A strong alliance between people with HD or sequelae, and clear-sighted scientific professionals, can help a lot. When backed by philanthropic friends of people with HD, such an alliance can help create islands of success. Such islands of success can be expanded to cover the whole globe in success. 

 

It would be good, in this COVID-19 era, to provide prolonged anti-microbial protection to every person with LLp HD. That is the cornerstone of defeating HD, and of a humane, respectful approach to LLp HD patients. Many esteemed colleagues on the front-lines know all this already. 

 

Wouldn't it be good to succeed? The most important step is to start caring better for all LL patients, right now, especially with prolonged anti-microbial protection. 

 

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/f79531e3-900a-4b22-adef-92e77623157a%40googlegroups.com.