Saturday, October 21, 2017 | ePaper

Adequate funds is the key to leprosy eradication

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Although leprosy is curable and - if diagnosed in time - disabilities resulting from this disease can be prevented. Leprosy continues to pose serious health and other problems for us. It is one of the oldest diseases and people having affected with leprosy, along with their family members, are being despised and abandoned. They suffer multiple forms of discrimination, including denial of access to work, education or even community living.
According to National Leprosy Elimination Programme (NLEP) and The Leprosy Mission International-Bangladesh (TLMI-B), annually on an average 3500 new leprosy cases are detected in the country in the recent years. About 10 percent of them later turn disabled due to failure of taking timely treatment.
The disease is an infection caused by slow-growing bacteria called Mycobacterium leprae. However, if left untreated, it can affect the nerves, skin, eyes, and lining of the nose (nasal mucosa). The nerve damage can result in crippling of hands and feet, paralysis, and blindness, said TLMI-B.
We need to make leprosy free society where there is no new leprosy case and all the needs of existing leprosy affected persons having been fully met. It is needed to reduce stigma in the community against leprosy, provide high quality service for all persons affected by leprosy, and integrate leprosy in the integrated health care delivery set-up for provision of quality services.
There are components such as training, smooth supply of Multi-drug therapy (MDT) drugs, early case detection, monitoring, launching awareness campaign, follow-up, carrying out regular contact survey, and skin camp for eradicating the disease. A lot of money is needed for performing the tasks, but these are being hampered reportedly due to lack of necessary funds.
According to NLEP sources, the government spent Tk. 15.58 lakh for the year 2012 under the leprosy elimination programme, Tk. 30 lakh in 2013, Tk. 23.50 lakh in 2014, Tk 23.50 lakh in 2015 and Tk. 25.50 lakh in 2016.
The sources, however, opined that that it would have been better if more money had been allocated for the programme.        
Jiptha Boiragee, programme support coordinator of TLMI-B, said the allocation is inadequate compared to the needs. He suggested increasing the amount in the interest of leprosy elimination programme.
The capacity of those working at the field level for health and leprosy eradication should be increased through regular training so that they can work better.
Skill of the medical officers on leprosy complications especially reaction management should be enhanced through training.
Early leprosy case detection is very important in leprosy elimination programme. Leprosy is such a disease for which initiative to detect new cases has to be taken. Those found to be affected show their negligence to take treatment for various reasons. If initiative is not taken to detect new cases and bring them under treatment, the goal of eradicating leprosy will not be achieved.        
It is important to hold regular contact/screen survey to find out cases if other people are found to be affected in an area. When a leprosy case is detected in an area, it is needed to carry out a survey in the areas to ascertain whether there is any other case in that area.     
Holding regular skin camp aimed at identifying new cases is needed to be done. Besides, it is important to pursue follow-up, and hold regular monitoring on the activities of leprosy elimination programme centrally.
But the matters, mentioned above, are being hampered due to constraint of money.     
Field visit and awareness raising activities by Tuberculosis Leprosy Control Assistants (TLCAs) and Programme Organizers (POs) are being disrupted for funds scarcity. They also failed to do other relevant works for lack of money. TLCAs and POs need necessary training on leprosy and to participate in awareness raising activities.
It is needed to raise the awareness levels of early signs of leprosy, ensure access to leprosy services and skills of health-care staff in diagnosing leprosy.
Ensuring availability of MDT drugs and their proper distribution at the community level is essential. Otherwise, all the efforts of case finding, diagnosis, classification and treatment are rendered meaningless.
There is no alternative to eradicating the disease as it continues to inflict sufferings on our people. But scarcity of money, needed for fighting the disease, is hindering our desired dream of making a leprosy-free Bangladesh.     
"If there were adequate financial allocation for the leprosy control, leprosy case detection and other related activities would have been done more smoothly, preventing the chance of disability caused by leprosy", said Boiragee.
International assistance to leprosy control programme in Bangladesh is decreasing gradually. It a matter of concern that leprosy elimination programme is being slowed down at the field level due to lack of necessary funds and trained employees. Few NGOs, working in the field with their limited resources amid dwindling of foreign funds, find it tough to handle the task. The government should come up with necessary steps, including allocating more funds for the programme, said sources.
If leprosy does not get adequate attention, it will bring our sufferings. It is hoped that the government, taking the matter into consideration, would attach due importance to the issue.
Bangkok Declaration, which was adopted at the International Leprosy Summit in 2013 in Bangkok, Thailand, called for reaffirming political commitment, enhancing financial allocations and including persons affected by leprosy.
The Summit noted that the challenges facing the high-burden countries include reducing Grade 2 disabilities in new cases through early case detection, access to equitable and quality health care, and promoting leprosy, wherever appropriate, as an integral part of neglected tropical diseases.
The Global Leprosy Strategy 2016-2020 aims at accelerating action towards a leprosy-free world. One of its three pillars called for strengthening government ownership, coordination and partnership.  
The strategy aims at early detection of leprosy disease and prompt treatment to prevent disability and reduce transmission of infection in the community. It is designed to achieve a long-term goal of a leprosy-free world, which refers to a situation wherein the community is free of morbidity, disabilities and social consequences due to leprosy.
The WHO priority to promote early detection and to monitor this through measuring disability in new case detection is a vital component to evaluate enhanced initiatives designed to reduce transmission. However, addressing the gap between the incidence and case detection of leprosy requires improved strategies for case detection, new tools for early diagnosis, and major efforts to improve community awareness and capacity of health staff to diagnose and manage leprosy and its complications.
Article 1 of the Universal Declaration of Human Rights states: "All human beings are born free and equal in dignity and rights." This includes every person affected by leprosy.
Solving the leprosy issue will help us in realizing a society where the fundamental rights and dignity of every human being is recognized and enjoyed by its citizens including persons with leprosy and disabilities.
We should let people know that this is not only a cause of injustice against leprosy victims, but also a major hindrance to overall development. If you hinder large number of people from relishing their rights, deny their development, and refuse to recognize their contribution, you cannot progress.
It is hoped that the leprosy issue would get its due attention in the greater interest of the nation. Any negligence, in this regard, will not augur well for us.    

(The writer, a journalist, can be reached at sissabuj@yahoo.com)
Md. Sazedul Islam

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