Leprosy demystified

MYTHS about leprosy were dispelled yesterday at the second global appeal to end discrimination against people affected by the disease. About 300 people, including world health officials and former leprosy patients, gathered at the Philippine International Convention Center (PICC) yesterday to sign a national declaration of support.

“Leprosy is a curable disease,” said Yohei Sasakawa, World Health Organization (WHO) goodwill ambassador for the elimination of leprosy and chairman of the Nippon Foundation. “Medicine is free all over the world. Therefore, there should be no discrimination.”

The effects of leprosy — sores, lesions, distorted limbs and disfigured faces — are difficult to hide. But the discrimination against leprosy sufferers is more insidious. The stigma against people affected by leprosy dates back to biblical times when “lepers” were described as “unclean” and were shunned by society.

Sadly, the stigma persists today.

Up to 100,000 people worldwide still suffer from leprosy-related discrimination. Unlike HIV/AIDS, another infectious disease that grappled with its own stigma, the fight against the stigma of leprosy has no glamour, no celebrity sheen. But the alienation of its sufferers is arguably more intense and absolute.

“Surviving leprosy is a big thing,” said Health Secretary Francisco Duque III. “But apparently, surviving the stigma that comes along with it is bigger. (Leprosy survivors) deserve a good life as much as we do.”

People affected by leprosy are forced to live on the margins of society. Before, they would be banished to isolated colonies. Today, even after being cured, they find it near impossible to work, go back to school, marry and reintegrate within the community. Their families and descendants are also usually discriminated against.

But these are the facts:

• Leprosy is a chronic, mildly infectious disease. It is extremely difficult to contract. 95 per cent of people have a natural immunity against it. It is not hereditary. And it is completely curable.

• Since the invention of Multi-Drug Therapy (MDT) in the 1980s, more than 14 million people have been cured, and 116 countries have eliminated the disease. In the Philippines MDT was first piloted in Ilocos Norte and Cebu in 1985 and then implemented across the country four years later. Leprosy ceased to be a public health problem in the country in 1998. At the end of 2005 the country’s prevalence rate is 0.36/10,000, far below the WHO’s ratio of one for every 10,000 population.

• But paradoxically the number of cases is on the rise. According to WHO reports, there were 3,130 new leprosy cases in the Philippines in 2005, a 38 per cent increase from the 2,254 cases reported in 2004. These cases made up 43 per cent of all new cases in the WHO’s Western Pacific Region — the most among the 37 member countries. China, second with 1,658 cases, made up 23 per cent. These numbers do not indicate an outbreak, said Dr. Francesca Gajete, national program manager of the country’s National Leprosy Control Program. Instead, the increase is chalked up to a more active and effection detection system. (In comparison, India, which ranks number one in terms of number of detected cases per year, records about 150,000 new cases annually).

• The country’s leprosy control program has an annual budget of P5 million, the majority of which is earmarked for an information and education campaign. Drugs and medication, which cost about P4 million a year, are donated by the WHO which, in turn, receives funding from the Nippon Foundation.

(Toronto-based Cheryl Chan is a regular contributor to PCIJ. She is in Manila for a month-long stay.)