Leprosy elimination

WHO Seventh Expert Committee (June 1997)

Main Recommendations

The major conclusions and recommendations of the Expert Committee are summarized below:

The Global Strategy for the Elimination of Leprosy, based on the implementation of MDT with case-finding, is working extremely well in reducing the prevalence of leprosy and should be continued. There is an important need to detect and treat the remaining undetected cases, for which special approaches, along with the extension of MDT services to all general health facilities, are required.

The progressive simplification of diagnostic and treatment technologies has continued to facilitate reaching more leprosy patients.

Based on a multicentre trial, it is considered that a single dose of a combination of rifampicin, ofloxacin and minocycline is an acceptable and cost-effective alternative regimen for the treatment of single-lesion PB leprosy. Furthermore, based on available information, it is possible that the duration of the current MDT regimen for MB leprosy could be shortened further to 12 months. A fresh strategy for the implementation of disability prevention and rehabilitation is called for to ensure a practical, community-oriented approach aimed at reaching the largest number of persons in need with-cost effective interventions.

The monitoring of elimination through essential indicators should continue. Information reported should be validated and analysed further through independent monitors in order to identify in good time problem situations needing action.

Anti-leprosy activities should become, and should remain beyond the year 2000, an integral part of general health services everywhere, and should also involve the communities to the fullest extent possible. Coordination between various agencies, including local and international nongovernmental organizations, should be consolidated.

It is recommended that research in leprosy be continued, especially in improving patient care and in addressing post-elimination issues. It is important to sustain anti-leprosy activities beyond the year 2000 in order to deal with the remaining problems, including new cases and persons with disability.