Leprosy Mailing List – August 8, 2021
Ref.: (LML) Leprosy elimination and Failures in Global Health
From: Sunil Deepak, Schio, Italy
Dear Pieter,
Two years ago, in July 2019 Dr. Madhukar Pai, Associate Director, McGill International TB Centre in Canada wrote an article on "Failures of Global Health" in a well-known journal. I read it recently. In this article he had wrote that we need to learn from our failures and presented a list of what he considered as the failures in global health. Here is a link to his article:
https://naturemicrobiologycommunity.nature.com/posts/51659-archive-of-failures-in-global-health
Point number 9 on Pai's list of Global Health failures is about the declaration of leprosy elimination in India in 2005. He wrote that "In 2005, India declared leprosy to be eliminated and scaled-back on its leprosy programmes. Today, according to WHO, India harbours 60 percent of the world's cases, with more than 100,000 new diagnoses each year" He linked this "failure" to an article that had appeared in New York Times about the shortcomings of the leprosy control programme in India.
Reading Pai's article made me think of a few considerations:
(1) I remembered the press conference in WHO in 2005 where the declaration about elimination of leprosy as a public health problem was presented as a great success story, though it was 5 years late compared to the original target of 2000. So in 15 years, how did that great success story turn into a "failure of global health"?
(2) During the 1990s and at least the first decade of 2000, we had a huge amount of discussions on the "elimination goal" and in some ways, those discussions have never gone away. For example, some of the issues raised by Joel about treatment of lepromatous leprosy are a continuation of those discussions. So, what else did we need to do to learn from our "failures"?
(3) Now that 15 years have passed since the achievement of elimination goal, not only in India, but globally across different endemic countries, what lessons can we draw out of it? Are we able to look back without prejudice and rancour and do an honest assessment of its pluses and minuses?
Warm regards,
Dr Sunil Deepak
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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