日本財団図書館（電子図書館）　Tokyo Meeting on achieving "Leprosy Elimination in India" June 3, 2002 Tokyo Japan Part1

TOKYO DECIARATION

"Achieving Leprosy Elimination in India "

The World Health Organization (WHO) and The Nippon Foundation/Sasakawa Memorial Health Foundation (TNF/SMHF), both deeply committed to the Global Leprosy Elimination Programme, and having a special concern in its progress in the countries of the South East Asian region of WHO, particularly India, decided to organize a meeting in Tokyo on 3 June 2002 on "Achieving Leprosy Elimination in India", more specifically in its seven high leprosy endemic states, to reaffirm political commitments of all parties concerned, and further strengthen the programme by forging closer working partnerships.

In response to the invitation, India sent a strong delegation of health authorities at the highest level, both national and the seven state governments concerned, headed by the Honorable Union Minister of Health and Family Welfare. Seven international NGOs, all belonging to the International Federation of Anti-Leprosy Associations (ILEP), as well as one major bilateral agency in the leprosy programme, DANLEP of the Danish Agency for Development Assistance (DANIDA), sent their representatives to participate in the meeting.

At the conclusion of the meeting, the participants unanimously agreed to endorse the following:

1.	The participants, fully reaffirm the goal of Elimination of Leprosy as a public health problem, as set out by the 44th World Health Assembly in 1991, and agree to work vigorously towards that goal, so that elimination of leprosy as a public health problem can be attained at the national level in India by the Year 2005. This will be the essential step towards our ultimate goal of creating a World without Leprosy.
2.	The participants agree that, to detect as many new cases as early as possible and ensure all of them complete a course of multidrug therapy (MDT), leprosy elimination activities must be available wherever the health care delivery system exists. This means full integration of leprosy activities into the general health services. This integration also makes it possible to sustain care for leprosy patients beyond the reaching of the current elimination goal.
3.	The participants acknowledge that the social aspects are significant areas waiting to be tackled, which includes the rehabilitation of people affected by the disease and their economic independence. For the time being, however, the public health control of leprosy infection has a higher priority. Hence, all efforts should be concentrated on case detection and case management based on MDT. Where resources and expertise are available, essential elements of prevention of deformities (POD) should be promoted. All messages put out for fundraising or in IEC material should always carry a positive image of leprosy.
4.	The participants, fully realizing the enormity of the task facing them and the need to establish a sense of ownership, agree to work closely together as equal partners in all aspects of the programme, including planning implementing monitoring and evaluation, as well as providing necessary resources. One key element in such partnership is a complete transparency of all actions taken by the partners. Therefore, there must be regular contacts among all partners through mechanisms by which interaction and exchanges of information and consultations could take place.
5.	To bring together all the ideas mentioned above into effective actions, the partners pledge to do the following:
	(a)	The Central Government and the seven State Governments agree to organize central and state level coordination meetings on their elimination programmes for 2003, covering plans of action, time schedules, budgets and resource allocations, before the end of November 2002, involving all working partners, viz. governments, WHO, NGOs and bilateral agencies.
	(b)	International NGOs, specifically ILEP agencies, who traditionally have deep concerns over the welfare of individual patients beyond cure of the infection itself, agree to fully support the current government's effort in the Elimination of Leprosy as a public health problem, while concurrently pursuing to improve the programme by facilitating POD and socio-economic rehabilitation activities whenever possible.
	(c)	WHO agrees to further promote the necessary activities to achieve leprosy elimination, by closely monitoring, and giving technical assistance where required.
	(d)	TNF/SMHF will make sure that necessary funds and material are provided in a timely manner and in the most effective way through WHO, or NGO's or any other partners, which will be an addition to what is already available through the regular budget of the national and state governments, the World Bank loan, and contributions, often in kind, from NGOs and bilateral agencies.