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Though the goal of elimination of leprosy as a public
health was globally attained by the end of 2000 and all WHO regions including
the SEA Region reached elimination levels by 2005, it needs emphasis that
elimination of leprosy as a public health problem was only an interim goal,
aimed at reducing the overall disease burden. Thus, new cases of leprosy
would continue to occur for some more time, with transmission occurring at
low levels.
The detection of leprosy cases, their treatment, management of complications and integration of cured
persons into the community will require new approaches in low endemic
situations. In addition, vertical or specialized services that have been in
existence in many endemic countries will not be cost-effective any more.
Finally, in low endemic situations when the disease is no
more a public health problem, there is danger of complacency, lessened
competency in diagnosing the disease, low priority, low political commitment
and inadequate resources.
Given the above scenario, the main regional issues and challenges identified during the post
elimination phase are:
 Sustaining political commitment and ensuring
adequate resources in order to sustain elimination at national level,
progress towards further reducing the burden of leprosy;
Strengthening integration of leprosy services
into the general health system through capacity building and skill
development, in order to ensure and sustain quality leprosy services,
including diagnosis and treatment;
Ensuring a wider coverage of leprosy services,
especially in currently under-served population groups such as remote rural
areas, urban slums, migrant labour;
Increasing and sustaining community awareness
through sustained advocacy and IEC activities to promote voluntary case
detection and decrease the stigma;
Minimizing/preventing operational factors,
such as wrong diagnosis, re-registration, delayed treatment completion,
delayed release from treatment;
Preventing discrimination and displacement of
leprosy affected and ensuring community based rehabilitation and integration
of cured/disabled leprosy persons into the community, and
Streamlining the MDT supply and stock
management at all levels, considering the low endemic situation.
In furtherance of the above, a bi-regional (SEARO-WPRO)
document to sustain quality leprosy services in Asia
and the Pacific beyond 2005 and to further reduce the leprosy problem is
developed. In addition, since the SEA Region continues to account for the
highest burden of leprosy, a ‘Regional
Strategy for Sustaining Leprosy Services and Further Reducing the Burden of
Leprosy: 2006-2010’ is also developed.
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