･ In many countries there is a need to change the attitude of health workers. Poor communication skills are a major problem which adds to stigmatization, Iow self esteem and hopelessness. Discriminatory attitudes of health personnel also need to be addressed.
･ Attention to potential social and psychological problems is paramount. Training curricula of schools and universities should also include social and psychological aspects.
･ Opportunities for self-expression are important for others to see that a person is more than his or her disease.
･ The potential for self-stigmatization is high, even amongst persons with no visible disabilities, if support is not available.
･ Attention to psycho-social issues by WHO and other influential organisations is of great rmportance.
Recommendations ：
1. Guidelines for appropriate terminology, taking into consideration cultural differences, should be developed with input from people affected by leprosy. These guidelines should be published and distributed.
2. Socio-economic improvement of persons affected by leprosy results in increased self-confidence and prevents marginalisation. Skills development training and loan schemes aid in empowerment and in ensuring that individuals lead productive lives with dignity as fully participating members of the community.
3. An inventory of discriminatory legislation and practices throughout the world should be compiled. Individuals and associations of people affected by leprosy should be mobilized and unite with others for the repeal of these laws and discriminatory practices.
4. Information materials should be developed with input from persons affected by leprosy that address both medical concerns and social and psychological needs.
5. Creative strategies should be developed that will renew the commitment of policy makers to issues related to leprosy.
6. Stigma related factors should be researched and analysed to develop appropriate health education strategies and define specific messages. Full use of the media should be made and societies of professional journalists and the media in general need to be pushed to keep issues related to leprosy on the agenda.
7. Health education about leprosy for the general public and health workers should be intensified in order to prevent the distribution of erroneous information.
8. Training in communication skills should be required for every health care worker.
9. Curricula of schools and universities should include socio-psychological aspects of leprosy.
10. Writings, music, art and other forms of self-expression by people affected by leprosy should be encouraged and utilized to create a positive image.
11. People affected by leprosy with potential leadership skills should be identified to participate in self advocacy workshops. This will promote the creation of self-help support groups.
