Md. Sazedul Islam :
Though a national health problem in the country, leprosy causes physical, social, economic and mental sufferings for the affected people. Though there has been a success regarding leprosy control, Bangladesh is still working to build a leprosy free country.
Leprosy is the most ancient bacterial disease in the history of mankind. It remains a public health problem in countries like Bangladesh. Leprosy is a chronic infectious disease, which is diagnosable and curable if recognized early and treated adequately.
Experts said, the issue of eradicating leprosy deserves due consideration in the national budget for the sake of our national interest, as it poses a huge economic setback on the nation. The government’s declaration of making a leprosy free country by 2030 is very important and to this end, massive anti-leprosy programmes should be taken in the country. Foreign funding for leprosy programmes is decreasing day by day. Hence, initiative from the government is a must for achieving the target.
They said, the impact of leprosy is significant. People with leprosy and their families experience income loss and unemployment because of visible impairments, leprosy related-stigma and high cost of leprosy.
Leprosy patients encounter social stigma that drives them to conceal their disease from neighbours and even their family members, and are faced with the burden of treatment costs and lost wages while still needing to feed their families.
When untreated, leprosy often leads to visible impairments of the hands, feet, eyes and face. These impairments, in combination with leprosy-related stigma, limit daily activities and people’s physical ability to perform work-related tasks. Therefore, many people affected with leprosy experience difficulty in finding employment, and fewer opportunities for education.
Thus, leprosy may have a large economic impact on people affected by leprosy and their families.
Hence, it is needed to chalk out anti-leprosy programmes for making a leprosy free country. Adequate financial allocation in the national budget is important for making the programme successful.
To achieve the target, we need to conduct regular contact surveys to find out new leprosy cases and bring them under treatment. Field level employees should be utilized and trained in this regard.
During the last 24 years till now, about 3000 new leprosy cases on an average are being detected in the country.
It means that there is a transmission of this disease. So it is needed to prevent it.
According to a research report, single-dose rifampicin (SDR) is the most effective approach to reducing the risk of developing leprosy among individuals. Necessary steps should be taken for scaling it up across the country for prevention of leprosy.
There is a dearth of facilities for managing leprosy complications at our hospitals. The government should strengthen the capacities of our hospitals so that necessary treatment facilities of such complications are available there.
There is stigma surrounding this disease, which is not only hampering its treatment but also the rights of leprosy affected people. Hence, a massive awareness campaign on leprosy should be launched across the country. Community Health Care Providers (CHCPs) at community clinics should be utilized for raising awareness at the grassroots level.
The mass media can also play an important role in raising awareness on leprosy.
Leprosy control contributes to at least three Sustainable Development Goals (SDGs): SDG 3 (good health and well-being for people, which includes Universal Health Coverage (UHC) or “leaving no one behind”), SDG 10 (reduced inequalities) and SDG 17 (partnerships for the goals). Bangladesh is now working to achieve the SDGs. If we fail to eradicate leprosy, it would be tough for us to achieve the SDGs.
We need to take steps so that people affected by leprosy can be included into general society with equivalent access to resources, services, rights and dignity in society, which will eventually lead to a Bangladesh without leprosy.
As part of anti-leprosy programme, we need to take up a number of steps such as leprosy early case detection, generate leprosy awareness for community people, economic empowerment of leprosy affected people, manage leprosy and its complications and prevent disability, combat stigma and ensure human rights.
Bangladesh has launched its National Leprosy Strategy (2023-2030), which calls for a strong national leprosy programme, integrated case management, and community-based inclusive implementation. The successful implementation of the Strategy demands significant funding and health staff capacity building.
Support regarding funding for new case detection initiatives has been reduced. The funding shortfall has also had a ripple effect on capacity building, patient follow-up during and after multi drug therapy (MDT) treatment, and engagement in leprosy related activities at the district and upazila levels.
Though Bangladesh has no discriminatory laws against persons affected by leprosy and their family members, however, inclusivity in areas like social, economic, educational and employment opportunities remains a challenge. To address this, leprosy experts recommend wide spread leprosy education, integration into healthcare, community counseling, and active anti-discrimination laws.
Taking up leprosy eradication programmes is important, but a number of issues are hampering this. Less importance is given to leprosy programmes, scarcity of funds for programmes and reduction of staff resulted in lack of initiative to detect new leprosy cases, lack of awareness raising activities, and less scope of training for employees and service providing people.
To build a leprosy-free country, it is first necessary to have a specific plan till the year 2030. The plan includes increasing the number of workers and building their capacity and skills, capacity building of the serving population (such as doctors, health workers), social awareness raising activities, actively identifying potential leprosy cases and ensuring medical care, including diagnosis.
It is needed to chalk out an operations plan for a leprosy free country. Hence, adequate financial allocation in the budget is imperative. If leprosy issues do not get proper attention in the budget, the sufferings, caused by it, will continue to haunt us, hampering our efforts to achieve the goal of national development.
(The author is a freelance journalist)