Leprosy program managers from 27 African countries gathered in Maputo, Mozambique, August 22-24 for the annual meeting covering countries in the WHO/AFRO region.

 The leprosy situation in the region is improving steadily if slowly. Forty-two countries had achieved elimination by the end of 2005, while four − DR Congo, Mozambique, Madagascar and Tanzania − had yet to do so.

 The regional prevalence rate at the end of 2005 was 0.63 per 10,000 population, while the new case detection rate was 0.68. The proportion of cases with Grade II disability remained at 10%.

 Operational problems identified include incomplete coverage for leprosy services, high staff turnover, inadequacy of trained personnel and a high deformity rate due to late detection.

 Among the recommendations adopted at the meeting:

　

 On August 24, the UN Sub-Commission on the Promotion and Protection of Human Rights endorsed the recommendations contained in a working paper on discrimination against leprosyaffected persons and their families compiled by Professor Yozo Yokota.

On implementation of new strategies − Countries will adopt and implement new global and regional strategies to further reduce the leprosy burden and sustain leprosy control activities; those that have not achieved the elimination threshold should continue elimination activities until they do.

On capacity-building − WHO will develop a training strategy and support countries in training health staff and reviewing training modules. Countries will maintain training and refreshment of health staff.

On social mobilization − WHO will update IEC materials. Countries will organize social mobilization activities in order to change the negative image of leprosy in communities.

On drug management − Countries will review drug management practices so as to avoid shortages and expired stocks.

　

 The Sub-Commission has now requested that the Human Rights Council appoint Professor Yokota as Special Rapporteur to undertake a full and comprehensive study of the topic and to produce a draft set of principles and guidelines to end discrimination.

　

 A Consensus Development Conference on Prevention of Disability was held in Cebu City, the Philippines, September 13-16. A consensus statement was due to be released shortly. See our next issue for full details.

 For a group of elderly persons affected by leprosy in Singapore, the move to a new residential facility last year has proved something of a mixed blessing. As Loh Kah Seng recounts on page 4, when they traded a dilapidated building for a clean, modern one, they also had to swap their own clothes for a uniform, and the relative privacy of smaller rooms for beds in a large ward.

 Catering to the needs of elderly persons affected by leprosy, while preserving their dignity, is a task requiring sensitivity and understanding − and this generation is particularly deserving.

 In Japan, the largest concern of the 3,000-plus residents of former sanatoria, whose average age is 78.2, is how they will live out their remaining days. In Brazil, there is now heated debate on the future of “colony hospitals,” as outside populations cast a covetous eye on colony premises and the privileges afforded those who live there.

 In Taiwan, too, the welfare of elderly persons affected by leprosy has become a focal point of human rights activists after the government decided to close down Laosheng Sanatorium to make way for a subway terminal, and move the aging, wheelchair-bound residents to a new facility. Worse, these plans proceeded without the consent of sanatorium residents, making the upheaval in their lives all the more traumatic.

 Speaking of affected persons in Japan, Dr. Fujio Ohtani has said: “Our society once dislocated them to where they are today. After they have made these places their homes for so many years, society should not move them once again.”

 Let us treat this aging generation with the respect and consideration it is due.

　

Yohei Sasakawa

Tatsuya Tanami

Jonathan Lloyd-Owen

Akiko Nozawa, James Huffman

Eiko Nishida

Natsuko Tominaga

5th Floor, Nippon Foundation Building, 1-2-2 Akasaka, Minato-ku, Tokyo 107-8404

Tel: +81-3-6229-5601

Fax: +81-3-6229-5602

smhf_an@tnfb.jp

　

With support from:

Sasakawa Memorial Health Foundation, The Nippon Foundation

　

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