Limit Leprosy Menace

Nepal has made significant strides in health sector, decreasing almost every kind of mortality, including infant, child and maternal mortality rates. Notable improvements have been made in overall life expectancy and child health.  Remarkable progress has been achieved in the prevention, control and treatment of many types of communicable and non-communicable diseases with persistent efforts by the governmental and non-governmental organisations.  Highly infectious diseases like polio and trachoma, which once posed a serious threat to public health, have been eradicated. There have also been dramatic decline in other infectious diseases. 

However, challenges still abound, as the sector grapples with many problems. Some diseases have proven to be too stubborn to be eliminated. Leprosy is one such disease. Though largely eradicated, the disease still continue to remain a major health issue in Madhes province. It is even making a comeback in the province's Mahottari district, with the cases rising to 100 in mid-January from 87 last year. Though a host of factors - such as poor sanitation, a lack of access to healthcare, a lack of awareness about its transmission, high poverty and limited hygiene in vulnerable population, among others – stand in the way of early diagnosis and treatment, what is proving the most problematic of all is stigma associated with it. 

Often referred to as "social disease" owing to social stigma it carries and the resulting isolation, discrimination and ostracism patients often face, the disease has continued to rear its ugly head again and again. Leprosy patients shy away from going to health institutions fearing that they will be shunned, delaying its detection and treatment. Superstitious belief and misconception that the disease is a punishment from god for a sin committed complicates the timely treatment. Even some interns and medical professional  treating patients have been found to be reluctant to touch them despite them being on treatment and hence posing no risk. 

The World Health Organisation (WHO) has set a global target to reduce leprosy prevalence to less than one case per 10,000 people, a goal the country has been striving to achieve. The district currently has a prevalence rate of 1.39 cases per 10,000 people. That said, the gains made in our battle against the disease is laudable, with the WHO duly recognising this achievement. In 2024. Nepal reported a 25 per cent decrease in new cases and nearly 50 per cent reduction in child cases compared with 2019. What is even more encouraging is that over 70 per cent of local units reported zero child cases for five consecutive years, bringing us closer to leprosy-free Nepal.

While the number of cases has significantly declined at the national level, interruption of leprosy transmission is yet to be achieved, as opined by one health expert. A total of 18 districts out of 77 remain high-risk areas. A leprosy officer of the district's Provincial Health Directorate lament that, though the province has seen an uptick in the number of cases, the provincial government has allocated only Rs. 1 million in the current fiscal year for leprosy investigation and control efforts. This dire situation calls for the government to spring into action and step up its fight against the disease. At a time when the rest of the world is achieving back-to-back success in its combat against many menacing diseases, we cannot risk falling behind.