Insights into Editorial: Another step in the battle against leprosy
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It usually affects the skin and peripheral nerves, but has a wide range of clinical manifestations.
The disease is characterized by long incubation period generally 5-7 years and is classified as paucibacillary or mulitbacillary, depending on the bacillary load. Leprosy is a leading cause of permanent physical disability.
Timely diagnosis and treatment of cases, before nerve damage has occurred, is the most effective way of preventing disability due to leprosy.
The WHO asked South-East Asian countries, including India which accounted for 60% of such cases worldwide in 2015, to focus on preventing disabilities in children.
Serious Concerns that need to address:
Over 110 Central and State laws discriminate against leprosy patients. These laws stigmatise and isolate leprosy patients and, coupled with age-old beliefs about leprosy, cause the patients untold suffering.
The biased provisions in these statutes were introduced prior to medical advancements. Now, modern medicine specifically, multi-drug therapy (MDT) completely cures the disease.
According to WHO, leprosy affected 2,12,000 people globally in 2015.
India alone reported 1,27,326 new cases, accounting for 60% of new cases globally.
Of the new cases, 8.9% were children and 6.7% presented with visible deformities. The remaining 10,286 new cases (5%) were reported by 92 countries. Thirty countries reported zero new cases.
India is among the 22 countries considered as having a “high burden for leprosy” along with high transmission by WHO.
Lack of awareness, myths, socio-cultural beliefs, and the stigma attached to leprosy are perhaps the most pressing problems before public health activists today.
Context: Amendments to laws that discriminate against leprosy patients: The Personal Laws (Amendment) Bill, 2018:
The Personal Laws (Amendment) Bill, 2018, seeks to make a start in amending some of the statutes.
It attempts to end the discrimination against leprosy persons in various central laws: The Divorce Act, 1869; the Dissolution of Muslim Marriages Act, 1939; the Special Marriage Act, 1954; the Hindu Marriage Act, 1955; and the Hindu Adoptions and Maintenance Act of 1956.
The Bill eliminates leprosy as a ground for dissolution of marriage or divorce. The amendments introduced in the Bill omit the provisions which stigmatise and discriminate against leprosy-affected persons.
The Bill is meant to provide for the integration of leprosy patients into the mainstream.
Amendments that added now: Already proposed by various Institutions:
The Rajya Sabha Committee on Petitions, in its 131st Report on ‘Petition praying for integration and empowerment of leprosy-affected persons’, had examined various statutes and desired that concerned Ministries and State governments urgently wipe clean the anachronistic and discriminatory provisions in prevalent statutes.
The Law Commission of India, in its 256th Report, ‘Eliminating discrimination against persons affected by leprosy’, had also recommended removing the discriminatory provisions in various statutes against leprosy patients.
The proposed law follows a National Human Rights Commission (NHRC) recommendation a decade ago to introduce amendments in personal laws and other statutes.
It is in keeping with the UN General Assembly Resolution of 2010 on the ‘Elimination of discrimination against persons affected by leprosy and their family members’ that it was introduced. India has signed and ratified the Resolution.
Government Initiatives in Recently:
The Government announced the three-pronged strategy for early detection of leprosy cases in the community was introduced in 2016 under the National Health Mission, especially in the hard-to-reach areas.
A special Leprosy Case Detection Campaign was carried out in 2016. As a result, more than 32000 cases were confirmed and were put on treatment.
In addition, persons who are in close contact with the patients were also given medicine to reduce the chances of occurrence of the disease in them.
There is a need to call for a collective effort to completely eliminate the ‘treatable disease’ of leprosy from India.
Anti-Leprosy Day was celebrated all over India on 30th of January. On this event, a campaign named as the ‘Sparsh’ Leprosy Awareness Campaign, is being organized in all the Gram sabhas all through the nation.
Mahatma Gandhi had an enduring concern for people afflicted with leprosy. His vision was not just to treat them, but also to bring them to mainstream to our society.
India, which is among the endemic countries, has been advised to include strategic interventions in national plans to meet the new targets, such as screening all close contacts of persons affected by leprosy; promoting a shorter and uniform treatment regimen, and incorporating specific interventions against stigmatisation and discrimination.
As a country, we have to leave no stone unturned to not just reach the last mile but also to work together to eliminate the social stigma attached with this disease.