Leprosy (Hansen's disease)
- Leprosy is a chronic infectious disease caused by a slow-growing bacteria, Mycobacterium leprae (M. leprae).
- The incubation period can range from 3 to 20 years.
- Leprosy is not highly infectious. It is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases.
- An infectious case is rendered non-infectious after the very first dose of treatment.
- Leprosy mainly affects the skin and peripheral nerves.
- If left untreated, it can damage the nerves, leading to loss of sensation and the ability to sweat in the extremities and paralysis of muscles in the hands, feet and face.
- In 1981, a WHO study group recommended multidrug therapy
- Since 1995, WHO has been providing free multidrug therapy for all patients in the world, initially through a fund provided by the Nippon Foundation and currently through donations provided by Novartis Foundation for Sustainable Development.
- Multidrug therapy comprises three drugs: dapsone, rifampicin and clofazimine. Rifampicin and clofazimine were discovered in the early 1960s.
- Multidrug therapy effectively kills M. leprae and cures the patient.
- Multidrug therapy is safe, effective and easily administered under field conditions.
- Treatment provided in the early stages averts disability.
- Multidrug therapy is available in convenient monthly calendar blister packs.
- WHO estimates that early detection and treatment with multidrug therapy has prevented about four million people from becoming disabled.
- Multidrug therapy is very cost-effective as a health intervention, considering the economic and social losses averted.
Elimination of leprosy as a public health problem
- Elimination does not mean there are no cases of leprosy in a country.
- The technical definition of leprosy elimination (less than one case per 10 000 of population) was endorsed by WHO's Member States during the World Health Assembly in 1991.
- The target was achieved globally in 2000. WHO's Western Pacific Region met the target in 1991, the very year the target was set.
- 34 of the 37 countries and areas in the Western Pacific Region have eliminated leprosy, but many people are still affected (2873 cases reported in the Philippines in 2010).
- The Federated States of Micronesia, Kiribati and the Marshall Islands have not achieved leprosy elimination.
- Leprosy is considered one of the neglected tropical diseases.
- Treatment with multidrug therapy is not the end of care for a person affected with leprosy.
- A person affected with leprosy who does not receive treatment, or whose diagnosis and treatment are late, may suffer from disabilities in the eyes, hands and feet.
- These physical disabilities are often accompanied by the social rejection and mental suffering caused by stigma and discrimination.
- People affected by leprosy need counselling and rehabilitation
- Efforts to fight stigma and discrimination must also be increased.
Integrated approach to leprosy services
- Leprosy control activities should be implemented by the general health services and specialty/referral facilities.
- There should be a smooth referral system. This is an integrated approach that improves access to treatment and reduces stigma and discrimination.
Burden of leprosy in the Western Pacific Region
- The prevalence of leprosy in the Western Pacific Region has declined by nearly 90% over the past 10 years.
- In 2010 there were 5,055 new cases reported and 8,386 cases were on treatment.
- Among the countries in the Western Pacific Region, in 2010, the Philippines reported the highest number of new cases (2,041).