Leprosy is a disease that many of us associate with Biblical times, a disease that surely must be extinct by now. Sadly that’s not the case. 31 January was World Leprosy Day, a yearly date to raise awareness of the disease and its impact on impoverished communities. Leprosy is a virus that affects the skin and nerves, is caused by the bacteria mycobacterium leprae. The good news is that it is treatable. However, if left untreated, it can cause progressive and permanent damage to the skin, nerves, limbs and eyes. Mycobacterium leprae multiplies slowly—the incubation period of the disease is about five years—and symptoms can take as long as two decades to appear.
Though there has been a large reduction in the dominance of the disease in the last 30 years, there is work to be done to eliminate leprosy, once and for all. It’s a tough challenge: for success, greater awareness, more resources and innovation are needed. Leprosy needs to be put back on the urgent global health agenda to make this happen, even though, historically, it has been one of the greatest public health success stories. International figures from the World Health Organisation (WHO) on leprosy highlight these early successes, showing that globally, leprosy has been reduced by 95 percent since the 1980s. This is due to the widespread availability of multidrug therapy (MDT), which has reached 16 million patients since 1981. MDT consists of three drugs (rifampicin, clofazimine and dapsone), two of which (rifampicin and clofazimine) were developed in the Novartis laboratories.
MDT has made it possible to treat patients, interrupt the transmission of leprosy and prevent disabilities. Even patients with the severest form of the disease show visible clinical improvement within weeks of starting treatment. Over the last 30 years, the Novartis Foundation has been part of this fight, working with global partners on early detection, the treatment of leprosy, the development of diagnostic tools and contact tracing with preventative treatment.
Worryingly, the case detection rate for leprosy has plateaued at about 200,000–250,000 new diagnoses per year over the past 10 years. The disease remains endemic in high-burden pockets in countries in Asia, Africa and Latin America. Sadly, new diagnoses occur in children as well as adults, indicating that the disease is still spreading, and that too many patients are diagnosed late and with irreversible disabilities.
The Novartis Foundation has launched a new leprosy elimination strategy developed with the top leprosy and disease elimination experts. The strategy includes four pillars: early detection and treatment, contact tracing and preventative treatment, strengthening of surveillance systems to become action-oriented and the development of diagnostic tools for faster and earlier diagnosis. The challenge of the last mile in this fight against leprosy is to interrupt transmission. Last year, Novartis renewed its commitment with the WHO to donate multi-drug therapy through the year 2020.
Photo Credit: Novartis Foundation
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