NEW DELHI: Leprosy “eliminated” from India 13 years ago might just be quietly re-growing to pose a fresh challenge to the health system. Over 1.35 lakh new cases were detected in 2016 — higher than 2015 when it was 1.25 lakh. India is home to about 60 per cent of the world’s leprosy patients.
“We have come a long way from the nineties when leprosy prevalence rate was 26 per 10,000 people,” Oommen C Kurian, fellow at think-tank Observer Research Foundation told The Sunday Standard. “However, as we shifted a decade ago from active surveillance to passive, voluntary case registration, thus keeping the patient numbers down on paper — the things on ground were not getting any better.”
Kurian believes there was pressure mounting on the country, and, possibly, the need to free up limited financial and manpower resources for HIV and other communicable diseases.
He also points out how health workers stopped making household visits to identify undetected cases, shifting instead to voluntary patient registration. Between 2004 and 2007, new case detection dropped by 75 per cent.
Sridhar Shandilya, a leprosy expert in Pune, said as India started deliberately under-reporting the disease in order to paint a good picture, it proved to be a self-goal. “Statistically, we were being fed that the disease is on a decline but instances of disabilities was on a rise. The leprosy programme in the last couple of years realised what a blunder it was doing by not identifying hidden cases.”
He emphasised that the senior political leaders do not seem to have learnt from mistakes of the past — referring to a statement by Union Health Minister J P Nadda that India was set to be “free” of leprosy in 2018 — a promise that sounds even shallower than the 2005 declaration.
Anil Kumar, head of the Union Health and Family Welfare Ministry's National Leprosy Eradication Programme, stressed the government declared India leprosy-free when the cases came down to less than 1 per 10,000 in 2005 as per the WHO guidelines. “Since last year, case detection campaigns are on in select districts. We realised that sending frontline workers to identify hidden cases was important.”
According to Nikita Sarah, head of advocacy and communications at the Leprosy Mission Trust India, it was important that the government had taken the required move of stepping up its efforts to send more and more patients for treatment rather than sticking to the rhetoric of elimination, more so when a drug resistant version of the disease is on the rise.