Yohei Sasakawa witnesses the UN human rights Sub-Commission pass a historic resolution on leprosy in Geneva, then visits the Democratic Republic of Congo and Timor-Leste to assess their efforts to achieve the elimination goal.

　

There are an estimated 20 million people in the world today who have recovered from leprosy. Including family members, there may be as many as 100 million people who have been affected directly or indirectly by the disease. Despite the fact that leprosy is now completely curable, it still stigmatizes people. Too often, education, job and marriage prospects suffer.
　Because of this deep-rooted prejudice and discrimination, in recent years I have made tackling the social aspects of the disease as important as addressing the medical aspects.
　In 2003, I had my first opportunity to brief members of the UN Sub-Commission on the Promotion and Protection of Human Rights on leprosy. It was the first time the subject had been brought before them. The following year, the Sub-Commission called for a preliminary investigation into leprosy as a human rights issue, appointing Professor Yozo Yokota to prepare a report on “Discrimination against Leprosy Victims and Their Families.” This August, I was present in Geneva when Professor Yokota presented his initial findings and recommendations at the 57th session of the Sub-Commission.

　

　

　I had the opportunity to address the session myself but after some brief remarks gave the microphone to four recovered persons (see page 2). It was the first time recovered persons had addressed a full session of the Sub-Commission, so it was a momentous occasion. They spoke from personal experience, and their words carried more weight than anything I could say.
　I am happy to record that the Sub-Commission passed a resolution endorsing the conclusions and recommendations contained in Professor Yokota's report, and he will now begin work on a detailed version.

　

　

The Democratic Republic of Congo is one of several African states yet to achieve elimination, so I was keen to make my first visit there ahead of the December 2005 target set by WHO.
　Formerly the Belgian Congo, and for a time known as Zaire, the DR Congo is today ruled by an interim government that is planning to hold democratic elections sometime in 2006.
　Beset by infrastructure difficulties as a result of long years of war, instability and mismanagement, but also due to its sheer size, the DR Congo faces many hurdles in the fight against leprosy. In recent years, the prevalence rate and detection rate have been rising, but this reflects concerted efforts by the authorities to track down hidden cases and reach more people. At the time of my visit, the prevalence rate stood at 1.91/10,000.
　On August 7, I traveled by road from the capital, Kinshasa, to Bas Congo Province, where I visited Kivuvu Hospital. Once a leprosarium, it is now leprosy referral center.
　After spending some time talking with the patients, I visited a village of recovered persons who make a modest living from agriculture and needlework. Children gathered round me, all smiles, and I asked one of them what he wanted to be when he grew up. “A doctor,” he replied. I truly hope this boy will go on to fulfill his dream; there is no reason why a healthy child should be denied a bright future, just because a parent has had leprosy.
　The next day I visited the WHO Office in Kinshasa for a briefing. Dr. Simon Van Nieuwenhove put matters in perspective when he said that the DR Congo is not so much a country but a continent, with all the implications that has for the logistics of leprosy elimination. Unfortunately, the areas where there are the most cases of leprosy are also those affected by the ongoing militia violence and unrest, making it harder to achieve effective health coverage.
　Although it won't be possible for the DR Congo to achieve elimination this year, Dr. J.N.Mputu Luengu B, the national leprosy program manager, told me that the country intends to reach the target by the end of 2007. With the support of WHO and other partners, as well as political commitment at the highest levels, I have every hope it will achieve this goal.
　I was fortunate to be able to spend some time with Health Minister Dr. Emile Bongeli Yeikelo Ya Ato and also called on Vice-President Zahidi Ngoma as well as the chief cabinet secretary. All voiced their support for elimination and promised to work for an end to discrimination. In particular, the health minister said he wanted to sit down with health officials, the WHO, and NGOs and map out a strategy for making more effective use of NGO support.
　For the second half of my stay, I traveled to Katanga Province in the southeast of the country. At 3.94/10,000, Katagana has the highest PR of any of the DR Congo's 11 provinces, and contributes one-third of the country's leprosy cases.
　After calling on the provincial governor in the capital, Lubumbashi, I took part in a press conference attended by some 50 local journalists. Speaking before the media, the health minister said that two of his relatives once had leprosy, which I felt was a brave admission, given the level of stigma that still exists.
　From Lubumbashi we drove north about 120 kilometers to Kapolowe, where there is a leprosy hospital, rehabilitation center and a village of recovered persons. What with patients, cured persons, hospital staff, dignitaries and area residents, there must have been several hundred people gathered for the occasion.
　I was taken on a tour of the wards and of the settlement, where I saw recovered persons engaged in making sandals and baskets. The patients each make three or four baskets a day, for which they earn the equivalent of $1. Given that average annual income in the DR Congo is about $100, this struck me as a good wage.
　I was told that there is a region of the DR Congo called Sasakawa. It is also a person's name meaning “one who gives light.” It's a name I want to live up to as I encourage all concerned in their efforts to help the DR Congo see its way to achieving elimination.

　

At the beginning of September I made a brief visit to Timor-Leste. The country gained its independence from Indonesia in 2002. With outside help, especially from the UN, East Timor is slowly finding its feet, but faces many challenges.
　The insurgency that preceeded its secession from Indonesia completely destroyed its infrastructure, and the health sector was no exception. Public health services are gradually being rebuilt, with the health ministry at the center of these efforts.
　At present, for a population of some 1 million people, there are only about 30 doctors. There is also a dearth of hospitals and health centers.
　Against this backdrop, leprosy elimination has made remarkable progress, thanks to the tremendous efforts of the WHO country representative, Dr. Alex Andjaparidze.
　According to the most up to date figures, 625 new patients have been registered in the past two years, and the current prevalence rate is 3.9/10,000. Over half ― or 388 ― live in an enclave called Oecusse.
　Traveling by UN helicopter, I flew one-and-a-half hours from the capital, Dili, to Oecusse. There, I took part in a ceremony to congratulate more than 200 people on the successful completion of their treatment. They ranged in age from children not yet in their teens to the elderly. I was delighted to see there was little evidence of deformity among them.
　Both President Kay Rala Xanana Gusmao and Health Minister Dr. Rui Maria de Araujo are committed to elimination. Given the small number of patients, and the fact they occupy one designated area, I believe a concentrated effort will see the elimination target achieved in due course.