4 February 2013

Nigeria: New Focus On Leprosy


Leprosy may be on the decline; but that is in the consciousness. In fact, it still poses a threat. Unlike other diseases that have gained greater attention over the years from various governments across the globe, the age-long disease has been relegated.

Though it receives some attention from the World Health Organisation (WHO), there seems to be limited effort at least by developing countries to ensure that it is no longer a threat in rural communities, where it is most prevalent. In Nigeria, the situation is not different going by the recent reports released by the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme indicating the need for more action in order to achieve the set target of reducing leprosy incidence to 1 in every 10,000 population. The report released at the 60th World Leprosy Day celebration showed that Nigeria is still endemic, with 3,623 cases recorded last year in addition to the existing recorded figure of over a million victims nationwide.

Defined by medical experts as a chronic, progressively infectious disease caused by mycobacterium leprae, which causes skin sores and also affects the eyes, mucous membranes and peripheral nerves, leprosy is considered an infectious disease that is contagious between people under rare circumstances. The disease has such devastating effects with general stigmatisation and discrimination of victims akin to HIV/AIDS. This is why most state governments establish special 'leper colonies' and centres that no one else visits except health workers and family members with strict instructions not to make physical contacts with inmates. In the eastern part of Nigeria, lepers are ostracised and left in the forest far from public with little or no care.

Though research has made diagnosis and treatment of leprosy remarkably easy today and most endemic countries are striving to fully integrate leprosy services into existing general health services, with trained personnel, much more needs to be done to curtail the spread of the disease in Nigeria. Access to information, aggressive public enlightenment, diagnosis and treatment with multidrug therapy (MDT) remain key elements in the strategy to eliminate the disease. The WHO has made provision of MDT treatment free of charge to all patients worldwide since 1995, and provides a simple yet highly effective cure for all types of leprosy. However, these drugs are not easily available in Nigeria as most leprosy centres consistently complain of drug shortage on their shelves.

Records show that between 2007 and 2010 most countries that were previously highly endemic for leprosy have achieved elimination at the national level and are intensifying their efforts at regional and district levels. This is why it is imperative for Nigerian health officials to take a cue from their counterparts and fashion out ways of addressing the problem.

It is indeed shameful that in the 21st century, Nigeria would still be having leprosy as a major challenge in its health planning programme. Government should therefore make concerted efforts to ensure that no more new cases of leprosy manifest in the country. Similarly, nongovernmental organisations should have a role to play in this direction, while governments intensify training and deployment of more health personnel to rural areas. Also, community leaders and religious bodies should be mobilised into the enlightenment programme for maximum impact to be achieved. Beyond these however is the need for proper funding of treatment of victims and prevention of new cases to stop them from developing into serious forms that cause disability.

It is critical that the proposal by the Federal Ministry of Health to launch an integrated multi-year national plan for the control and elimination of neglected tropical diseases (NTDs) this week should form the basis for blueprint that would be vigorously implemented towards eliminating leprosy and other diseases by 2020 as the government has pledged. Unless these measures are taken and sustained, the battle to conquer this disfiguring disease in the near term would have been lost.

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