Feasibility of elimination FAQ
Is the goal of elimination reasonable and feasible? What urgent actions must be taken now to ensure the attainment of the goal?
The goal of eliminating leprosy is both reasonable and feasible. However, progress being made in some countries remains slow, mainly because the geographic coverage of MDT services is still not wide enough, or the services are too rigid or too sophisticated to reach every patient in every village.
A move away from "vertical" - often highly centralised - leprosy services is underway in most endemic countries, although this process is being implemented at different rates and different levels of success. This more simplified approach to treatment uses the general health worker at village level and making the MDT services "patient-friendly" and uncomplicated, and will reduce the stigma of patients having to attend "specialised" clinics, often segregated from other patients.
Measures previously taken to stimulate public awareness in the community and detect "hidden" cases will need to be continued. MDT needs to be made readily available at the community level, and special projects may be necessary to tackle difficult-to-reach areas and populations. Careful monitoring to measure the impact of these activities at district, regional and national levels will be essential. In addition, the momentum gained so far needs to be solidly maintained and accelerated still further.
This is an historic opportunity to erase leprosy from the long list of diseases that confront many communities in the world.
What are the essential requirements for attaining the elimination goal?
The ingredients for success are as follows:
- sustained high levels of MDT coverage, especially in terms of reaching every patient in every village
- high levels of compliance and treatment completion rates
- effective case-detection to the point where all leprosy cases of consequence in the community are promptly cured with MDT
- accelerating the national plans of action and constant monitoring of the progress made
- increased political commitment and mobilization of additional resources.