Start all over again

IN the year 2005, a confident India prematurely declared to the world that it had eliminated leprosy as a public health problem. Twelve years later, it seemed unsure, with Finance Minister Arun Jaitley announcing in the Budget speech that the country would eliminate leprosy by 2018; an apparent admission that the disease was quite alive. The alarm had gone off after the Union Health Ministry reported that over a lakh new cases had been detected. 

There are several reasons for the resurgence. The National Leprosy Elimination Programme was rather hastily integrated into the broader healthcare spectrum in 2005, hitting the funding for leprosy prevention and awareness programmes. The stigma and social ostracism associated with the disease forces those afflicted with it into the cold background. They are ghettoised in leprosy colonies, existing in most towns, away from public glare. Social conditioning is oblivious to the management of the disease and its treatment, the multi-drug therapy that makes patients non-contagious. Until recently, leprosy was a ground for divorce, even though it is curable if detected in time. Unlike a relentless nationwide door-to-door Pulse Polio programme, a blitzkrieg campaign against leprosy has been absent. 

The picture is grim: India accounts for nearly 58 per cent of the world’s leprosy cases. A dedicated wider diffusion of information is required. Amitabh Bachchan’s ‘Do boond zindagi ki’ appeal found resonance in the anti-polio drive. A celebrity can be roped in as a driver of change to remove fear from the minds of patients and society. There is a need for massive resource allocation. Surveillance must be strengthened, each case recorded and fresh ones identified. Post-treatment follow-up is also essential to check for any drug-resistant strain or relapse. Unless the clock is turned back and a robust monitoring mechanism — led by frontline health workers and volunteers — evolved, all efforts would have been lost to the lurking disease. India can’t afford to get it wrong again.