9th Postgraduate Course in Infectious and Tropical Diseases

By: FRANCESCA CANDO-GAJETE,MD,MHA

Manager- National Leprosy Control Program

National Center for Disease Prevention and Control

Department of Health

Improve case

detection and

Surveillance

System in low

endemicity

settings

Advocacy for

Leprosy and

Human

Dignity with

Leprosy

Recoverers

Ensure the

availability

of

adequate

anti-leprosy

drugs

NLCP Ongoing and Planned projects for 2013

Mission : the provision of a comprehesive, integrated quality leprosy services at all levels of health care with the active participation of persons affected by leprosy & other stakeholders

Integration of

Leprosy

control and

other

services at

local level

Strengthen

the

collaboration

of partners

and other

stakeholders

61 2 3 4 5

RESEARCH – BOD, Retrospective study of leprosy cases, national rapid tests among HHC

Best Practices and Innovative Ideas Contest

Changed landscape in leprosy prevalence and developments in public health approaches lead ask for cost-effective and strategic activities

E-learning

Mobile health

Contact tracing

School-based programs

Data management

RPOID SAPEL

Participation of Leprosy Recoverers

Consultation, engagement and collaborational arrangements (MOA, MOU) with public and private partners

Prevention

and

reduction of

disabilities

from

leprosy

For 2013-2018, we aim to:

•Decrease by 50% the identified hyperendemicmunicipalities by 2018;•Establish referral units in all regions;•Establish the Standardized E-Reporting system for NLCP;•Develop the Counselling Modules for Frontline Healthworkers; •Develop the hub for the Community of Practice;•Develop Leprosy Research Agenda with RITM & Leonard Wood; and

•Identify and declare “Leprosy-free municipalities”

NLCP TARGET

Leprosy Elimination in the Philippines

1982 1986 1998 2000 2002 20072005 2010

MDTPiloted

Global appeal

•1st National Leprosy Summit•MOA w/ PDS

•National Skin Disease Awareness Week•A.O. 2005-2013- 8 Sanitaria conversion

Dr. Jose N.Rodriguez

Award

DecentralizationEliminated

as publichealth

problemPR 0.9/10,000

NLCP EstablishedPR 7.2/ 10,000(32,570 cases)

PR 0.31/10,000

Leprosy Elimination in WPR

1985

MDT initiated

1991 1994 1999

Post elimination surveillance

system (PESS)

guidelines developed

Regional elimination

achieved

2000

Elimination in 35 /37 countries

2004 2009

Bi-Regional meeting with

SEARO on Post-

Elimination Strategies

100% MDT coverage

2010

WPR Framework for

Leprosy

for PICs

Elimination in 34/37 countries

Trends in the Detection of New Cases of Leprosy(2004 – 2011)

No. of new cases detected

WHO Region 20112010200920082007200620052004

12 67325 34528 93529 81434 46834 48045 17946 918African

36 83237 74040 47441 89142 13547 61241 95252 662Americas

160 132156 254166 115167 505171 576

174 118

201 635298 603South East Asia

4 3464 0804 0293 9384 0913 2613 1333 392Eastern Mediterranean

5 0925 0555 2435 8595 8636 1907 1376 216Western Pacific

219 075228 474244 796249 007258 133

265 661

299 036407 791TOTAL

Registered Prevalence of Leprosy & # of New Cases Detected in 105 Countries or Territories (2011 & 1st Q of 2012)

No. of new cases detected and case-

detection rate, 2011

No. of cases registered and the prevalence, 1st

Q 2012

WHO Region

12 673 (3.14)15 006 (0.37)African

36 832 (4.18)34 801 (0.40)Americas

160 132 (8.75)117 147 (0.64)South East Asia

4 346 (0.71)7 368 (0.12)Eastern Mediterranean

5 092 (0.30)7 619 (0.05)Western Pacific

219 075 (4.06)181 941 (0.34)TOTAL

Number of cases of leprosy (rate/100 000 population) w/ Grade 2 disabilities detected among new cases (2005 – 2011)

Year

WHO Region

2011201020092008200720062005

1 446 (0.36)

2 685 (0.40)

3 146 (0.41)

3 458 (0.51)

3 570 (0.51)

3 244 (0.46)

4 562 (0.62)

African

2 382 (0.27)

2 423 (0.27)

2 645 (0.30)

2 512 (0.29)

3 431 (0.42)

2 302 (0.27)

2 107 (0.25)

Americas

753

(0.12)

729

(0.12)

608

(0.11)

687

(0.14)

466

(0.10)

384

(0.08)

335

(0.07)

Eastern Mediterranean

7 095

(0.39)

6 912

(0.39)

7 286

(0.41)

6 891

(0.39)

6 332

(0.37)

5 791

(0.35)

6 209

(0.37)

South East Asia

549

(0.03)

526

(0.03)

635

(0.04)

592

(0.03)

604

(0.03)

671

(0.04)

673

(0.04)

Western Pacific

12 225 (0.23)

13 275 (0.23)

14 320 (0.25)

14 140 (0.25)

14 403 (0.26)

12 392 (0.23)

13 886 (0.25)

TOTAL

0% 5% 10% 15% 20% 25% 30% 35%

Other countries

Lao People's Democratic Republic

Kiribati

Marshall Islands

Micronesia (Federated States of)

Malaysia

Papua New Guinea

Cambodia

Viet Nam

China

Philippines

Distribution of new leprosy cases, 2011

• 2006- Mr. Yohei Sasakawa, Chairman of The Nippon Foundation led an annual Global Appeal to End Stigma and Discrimination against People Affected by Leprosy

• This appeal has been an attempt, both to raise public awareness through the media, and to draw in the support of world leaders, representatives of people affected by leprosy, and organizations concerned with human rights in general

• On discrimination: "We don't get complaints, because people affected by leprosy don't realize these are human rights issues as well"

-Cecilia Quisumbing, Commission on Human Rights

• We must raise awareness of UN-adopted Principles and Guidelines to end discrimination against people affected by leprosy and their families

Global Appeal 2007Held in the Philippines and spearheaded

by the National Leprosy Control Program,

the 2007 Global Appeal was signed by 16

people affected by leprosy from 13

countries together with the WHO

Goodwill Ambassador Yohei Sasakawa.

Their message: “Silence on the issue is

not acceptable. We urge you to join us in

the fight to end social injustice”.

The Evolution of the Global Appeal• 2008- emphasized that diagnosed and treated promptly,

leprosy leaves no trace. Far harder to remove is the age-old stigma.

• 2009- called for people to stop using the word “leper”

• 2010- urges all physicians, health professionals and civil society to engage themselves in combating all forms of prejudice and discrimination.

- Further, research centres should acknowledge leprosy as a major public health problem and continue to research into it.

The Evolution of the Global Appeal• 2011- all National Medical Associations defend the

right of people affected by leprosy and their family members to be treated with dignity and free from any kind of prejudice or discrimination.

• 2012- Leprosy is curable, treatment is free and there must be no more social stigma in the twenty-first century.

-“A patient is not really cured until stigma ends”

Why participate?

• There are many myths and misconceptions about leprosy. As members of the medical

profession, we have the first responsibility to set the record straight

THE FACTS

• Leprosy is a mildly infectious disease.

• It is not spread by casual contact.

• It is curable with antibiotics that kill the bacteria and stop the disease from spreading.

THE FACTS

• Early diagnosis and prompt treatment help prevent the onset of disability and deformity associated with leprosy.

• There are no medical grounds for isolating a person with the disease

• Treatment is FREE

“Start focusing on being everything to someone. Helping or pleasing everyone is impossible. But making one person smile can

change the world. Maybe not the whole world, but their world”