Leprosy Mailing List – August 9, 2021
Ref.: (LML) Leprosy elimination and Failures in Global Health
From: Wim Theuvenet, Apeldoorn, the Netherlands
Dear Pieter,
Thanks for the mail of August 8th and the invitation to learn from our failures!
As stated,
" (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 "
What went wrong??
A personal analysis:
In the late 1980's the WHO, headed in this discussion by Dr Noordeen, announced that they would not consider "Leprosy as a Public Health problem" anymore in those countries where the prevalence would become less than 1:10.000".
From Anandaban Leprosy Hospital, Nepal, we directly expressed our great concern that the prevalence was used as a parameter for this, and not the incidence, as was and is common sense in all infectious diseases up to today (see Covid). And when it became obvious that the WHO would not deviate from its set course, we made a plea for a well-functioning monitoring system to assess the incidence in highly endemic pockets.
Now 25 years later much has been achieved, but also too many leprosy control programs have collapsed, and badly needed expertise is lost.
Do we have enough reliable data to assess the present leprosy situation?
In my small field of expertise, 'leprosy reconstructive surgery" is often not available anymore to scores of patients, not to mention the issue how to timely detect nerve damage and to treat immune reactions properly.
What can be learnt from this?
Less politics and more expertise when addressing infectious disease programs at a global and national level?
How to restore the strength of leprosy eradication programs, this to the benefit for those affected by leprosy today and tomorrow??
Best regards,
Wim Theuvenet
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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