21/12/2017 11:21 GMT | Updated 21/12/2017 11:21 GMT

On The Journey To Reach A Billion, We Mustn’t Forget The Missing Millions

Fiona Graham
Ankitkumar, a young boy who was found and treated for leprosy in Lepra's active case finding screening survey

The latest progress report by Uniting to Combat Neglected Tropical Diseases (NTDs) celebrates the tremendous work to beat NTDs. This effort has ensured treatment for over a billion people in a year and it’s working steadily towards the aim to control, eliminate and eradicate 10 focus NTDs by 2020.

Leprosy is one of the 10 focus NTDs and the report highlights that 65% of priority countries have seen a decrease in new cases compared to 2011. This suggests that the numbers of people affected are declining, however, in India –a country that holds over half of the global leprosy burden, the numbers of reported cases are at their highest for 10 years. Cases of leprosy are also much higher than those we see each year and credible estimates put the actual figures at about ten times higher. This means that approximately 3-4 million people at this moment are suffering with this disease.

One of the key ways to find and treat people with leprosy is with active case finding. This is where outreach workers visit communities and households, often in rural and tribal areas and screen people for undiagnosed leprosy. A model which has played a significant part in Lepra finding, diagnosing and treating over 14,000 people affected by leprosy last year.

Ankitkumar (pictured) was one of the children found in a recent active case finding survey in Bihar India. He suffered with leprosy for three years as a consequence of a misdiagnosis, but thankfully, he received treatment before he developed any serious disability. Today he is a happy boy, able to enjoy a full and active life—along with many others who benefited.

In addition to finding people living with undiagnosed leprosy, we need to strengthen existing healthcare systems to tackle this disease. Building the capacity of often under-developed and poorly resourced health systems will build a country’s ability to manage leprosy without the aid of others. This includes ensuring that local health professionals are trained to recognise leprosy for which the treatment is free, even if those local health professionals are private. Patients sometimes visit private health practitioners and village doctors as government facilities are often very far away. Knowledge of leprosy is low with many of these health professionals and so people are often misdiagnosed or provided with herbal medicines to treat the disease - causing their disabilities to get worse the longer they’re left.

Simon Rawles
Residents of a leprosy colony in the Indian state of Odisha

The World Health Organisation (WHO) was overly-ambitious to aim to eliminate leprosy by 2020. The disease can take up to twenty years to manifest itself, so the target was unrealistic and unachievable. This has led to many governments thus giving up completely at trying reaching this epidemiologically unattainable target.

There’s only two years left to meet the 2020 aim to beat 10 of the focus NTDs. Yet to beat leprosy needs sustained work over many years, as the disease incubates for decades and is a challenge to diagnose early. To beat leprosy we need to focus on activities that work to reduce the numbers of people affected, such as by increasing active case finding activities and training greater numbers of private healthcare staff to ensure more people are treated for this disease.

If efforts aren’t increased, we risk forgetting the missing millions and leprosy will continue to remain one of the most neglected of neglected tropical diseases.

To find out more about Lepra’s workvisit