Annual State Leprosy Officers Conference
In 2005, India achieved the WHO-set target of eliminating leprosy as a public health problem—reducing the number of cases to below the level of 1 per 10,000 people at the national level. This was the result of the health ministry, the WHO and NGOs working together. This historic achievement earned India respect and praise around the world. Since achieving elimination, however, the number of new patients has not been falling at the same rate as before. Indeed, in recent years, the number has more or less leveled off.
When you set a goal and devote your efforts to achieving it, the energy and motivation to continue often weaken once you achieve that goal—even though it may not be the final solution. This is true of anything, and leprosy is no different. I have seen this for myself in countries around the world. Once the elimination target has been achieved, efforts ease off, budgets and personnel are reduced and leprosy becomes less of a priority.
In India, I hear that the post of leprosy officer is vacant in a number of districts, and that the number of medical personnel with expert knowledge of leprosy is declining year by year. If nothing is done about this, case numbers will stop falling and may even start to increase. What’s more, there are those who fear that the actual number of cases today is larger than the reported number.
I’m sure I don’t need to remind you, but “elimination” of leprosy is just a milestone on the road to a world without leprosy; it is not the end goal.
What I am afraid of is this: I fear that once a significant target such as “elimination” has been achieved, and if the relative priority of leprosy in terms of budget, etc., is lowered, you may mistakenly believe that the importance of the leprosy program itself has lessened. Passing the elimination milestone is not an excuse for easing off. If leprosy makes a comeback as a result, then what India achieved six years ago would be in vain.
Therefore, it is my hope that you will once again share your strong commitment with those working in leprosy in every state, and revitalize India’s leprosy program. Of course, compared to when elimination was achieved six years ago, the situation has changed. For example, reaching patients may be getting harder; and, because of budget cutbacks, perhaps anti-leprosy measures are not being implemented as widely as before. Under these circumstances, you will have to become even more strategic, and adopt more innovative and effective approaches. In a country as vast and diversified as India, policies are needed not only for state and district level, but for every town and village. As to what those measures should be, you, with your knowledge of the situation on the ground, are in the best position to judge.
Let me explain why I remain thoroughly committed to leprosy control. This is not just about reducing the number of people suffering from the disease. It is also important for another reason. For a long time, as you know, patients have suffered not only from the disease, but also from the discrimination it causes. The problems of disease and discrimination are interwoven.
Unfortunately, people who get leprosy, especially those who develop visible disabilities, are discriminated against. Therefore, keeping new case numbers from increasing and seeing that patients are cured before they develop disabilities are linked to reducing the number of people who suffer such discrimination. In other words, your efforts are vital to tackling both the disease and the discrimination it causes.
Please never forget that with each action you take, you are helping to transform the life of every person affected by leprosy. So when you return to work, while numerical targets are important, please keep in mind that there is a life behind each number.
At this conference, you will be exchanging views on what needs to be done based on the situation in each state and district. I hope you will share with one another whatever improvements and innovations you come up with. It is my sincere hope that, through your efforts, as many people as possible will be rescued from the suffering that leprosy causes.