It’s Time to Move Leprosy to the Annals of History
By Bill Gallo, MBA
World Leprosy Day is on January 31 when the international community advocates for the rights of people who have experienced Hansen’s disease and joins in the work to combat the medical and social implications of this neglected tropical disease.
Leprosy is not a disease of the past. While many people know leprosy only from ancient Biblical stories, every year 200,000 new patients are diagnosed and an estimated 5.5 million people are afflicted by the disease, mostly in India, Indonesia, Myanmar, Brazil and Nigeria.
Leprosy, a neglected tropical disease also known as Hansen’s disease, has tormented humans throughout recorded history. But for the first time we have international consensus on a path to zero leprosy: no disease, no disability, and no discrimination.
The bacterial infection can affect nerves, skin, eyes and the lining of the nose, leading to skin lesions and nerve damage. Leprosy is cured by multi-drug therapy, a treatment that has been used for decades. However, if untreated, the nerve damage can result in crippling of hands and feet, paralysis, and blindness. Just as in ancient times, fear and misunderstanding about leprosy contribute to stigma and isolation for those affected.
A new Zero Leprosy Research Agenda provides a clear guide to prevent, diagnose, and eliminate leprosy once and for all. The plan will help researchers prioritize activities and maximize resources through collaboration on eight key areas: epidemiologic modeling, digital health, operational research, diagnostics, antibiotic prevention (known as post-exposure prophylaxis, PEP), vaccines, disability, and stigma.
One example involves a new treatment that can prevent the spread of leprosy. A single dose of the antibiotic rifampicin offers new possibilities to stop the transmission of leprosy to family members and neighbors of leprosy patients. The action plan will align researchers working on PEP in order to make it more effective, and will support countries that want to roll out and scale-up the approach.
In addition to leprosy prevention, the research agenda calls for progress toward a diagnostic tool that accurately and efficiently identifies the infection. We know that early diagnosis is critical to prevent disabilities caused by the disease, but many people affected by leprosy receive late diagnoses, and as a result, delayed treatment. Experts in leprosy and diagnostics are convening in 2021 to create a target product profile (an in-depth description of an ideal tool) for a leprosy diagnostic, bringing us closer to a tool that will help us reach zero leprosy.
At the start of a new year we often pause to set goals for ourselves, but goals are unattainable without a strategy to achieve them. The international leprosy community has come together in a new and encouraging way to show how to achieve leprosy elimination. Each new innovation is a step closer to reaching no disease, no disability, and no discrimination or stigma so that we can finally make leprosy a disease of the past.
Bill Gallo, MBA, is the Director of the Global Partnership for Zero Leprosy (GPZL), a program of The Task Force for Global Health, which is a coalition of stakeholders committed to ending leprosy that facilitates alignment of the leprosy community to accelerate effective collaborative action toward the goal of zero leprosy: no disease, no disability, and no discrimination. GPZL convened the researchers who developed the new Zero Leprosy Research Agenda. The Task Force is an NGO that works in more than 150 countries to eliminate diseases and protect populations through programs in NTDs, access to vaccines, and health systems strengthening.