The world is making steady progress in the quest to become leprosy-free. Between 2016 and 2018 the number of new leprosy cases reported globally declined by more than 6000. India – the world’s most affected country – reduced the number of new cases reported by more than 15 000. The number of visible deformities at the time of leprosy diagnosis is now at 1.5 per million people, making the 2020 target of less than one per million people within reach. Member States are making concerted efforts to reduce leprosy-related stigma and discrimination, with India scrapping several discriminatory laws and Nepal looking to do the same. The lives of people affected by leprosy are improving. Barriers to tackling the disease are being overcome.
Further progress is needed to achieve the Global Leprosy Strategy’s targets of zero disabilities among new pediatric patients and a grade-2 disability rate of less than one case per million people. As the theme of this year’s World Leprosy Day emphasizes, ending leprosy-related stigma and discrimination will enhance early case detection and help us achieve a leprosy-free world. The evidence is clear. Stigma creates fear. Fear inhibits health-seeking. Delayed health-seeking causes late diagnosis. Late diagnosis can cause deformity and disability.
It is not only a question of health: It is also about rights. Across the world, people with leprosy are frequently barred from accessing public amenities, are not allowed to work, are divorced on account of the disease or stopped from travelling. Often these restrictions function at a social level. But they can also be sanctioned by outdated laws that no longer reflect a country’s social and political values, or its commitment to leaving no one behind. Our quest to advance the health and well-being of all people must be rights-based and people-focused. The human rights of persons affected by leprosy must be respected, protected and fulfilled.
To remove stigma and discrimination against persons affected by leprosy, and accelerate towards a leprosy-free future, Member States in the WHO South-East Asia Region and beyond can take advantage of several opportunities. Each one of them is reflected in a 2010 UN Resolution on eliminating leprosy-related discrimination, and in the Global Leprosy Strategy’s core pillars and targets.
First, persons affected by leprosy should be empowered to combat associated stigma. Social awareness campaigns that are led by persons affected by leprosy can dispel misinformation and the stigma that it promotes. High-level advocacy campaigns can secure political commitment and the funds needed to accelerate change. Religious and community leaders should be taken on board and provided guidance on how to inform and persuade people to join the fight against leprosy-related stigma. Accurate information is one of the most powerful tools we have.
Second, all discriminatory laws should be repealed. As the UN Human Rights Council continues to emphasize, statutes that discriminate against persons with leprosy are an affront to our common dignity and humanity. They have no place in today’s world. At present, 21 countries globally have discriminatory laws on the books, including five countries in the South-East Asia Region. The repeal in recent years of several discriminatory laws is to be welcomed. The Region’s progress must continue until all countries are free of discriminatory laws.
Third, all persons affected by leprosy should have access to social and financial support and rehabilitative services. Vocational training and community-based programmes are crucial to ensuring persons who have been deformed or disabled by leprosy can be productive members of society. To their credit, almost all leprosy-endemic countries have developed and are implementing programmes aimed at supporting the social and economic autonomy of persons affected by leprosy. It is essential that persons in affected communities are made aware of such services and know how to access them.
On World Leprosy Day, WHO reiterates its commitment to accelerating efforts to achieve a leprosy-free world. The South-East Asia Region has made commendable progress to detect and treat leprosy cases early and to end leprosy-related stigma and discrimination. Though both the Region and the world have officially eliminated leprosy as a public health problem, we must now go the extra mile and reach sub-national elimination in all affected areas. The targets of the Global Leprosy Strategy can be achieved. A leprosy-free world with zero disease, zero transmission, zero disability and zero stigma and discrimination is possible.