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India takes the fight against leprosy to people's doorsteps

November 9, 2018

The government of Delhi is set to kick off the door to door leprosy campaign from 10 November. With India accounting for 60% of new leprosy cases in the world every year, the door to door detection campaign launched in 2016 across India has proved critical in identifying new cases and ensuring early treatment and cure.

The leprosy Case Detection Campaign (lCDC) is the biggest such campaign anywhere in the world. It aims to detect cases in high-endemic districts and ensure early treatment of a disease which is the leading cause of disability among communicable diseases.

In 2005, India officially declared itself leprosy-free when new cases fell to less than one in 10,000. Yet, India still accounts for the largest number of leprosy affected people in the world.

In 2005, people thought elimination had been achieved and the problem was over. Funding for the leprosy program was reduced and attention shifted to other public health issues. The problem is that leprosy has an incubation period of six years, so people were not reporting the cases on time, or not at all. They would finally report it only in the event of a disability. In 2015, when we analyzed the data, we realized that cases of disability due to leprosy were going up and the campaign was launched. - Dr Anil Kumar, Deputy Director General, National leprosy Elimination Programme, Union Health Ministry

Regarded as the best campaign anywhere in the world, the door to door campaign for leprosy detection is done by a team of two people, one male and one female. "Since there is no pain, the affected person does not notice, and it spreads," says Dr Kumar. "It becomes hard to control then so this approach is effective as it helps detect cases early."

In 2016, when the program was launched, 35,000 new cases were detected, followed by 32,000 in 2017. This year, the government has plans to extend the coverage to more than 250 districts, says Dr Kumar. "In the last three years, we have detected and treated many cases and as a result, disability due to leprosy is going down. Transmission is also being interrupted."

Early detection and treatment are also critical to ensure people get access to the right kind of treatment.

"There is a lot of stigma around leprosy and people face ostracism," says Nikita Sarah, Head Advocacy & Communications, The Leprosy Mission, India. People tend to go to quacks and religious practitioners for a cure, when the reality is that if diagnosed early, the affected person can be fully treated."

As Sarah points out, the efficacy of the lCDC campaign is highlighted in the number of new cases being detected every year. "More people are being identified and there is also an awareness campaign being conducted alongside by the government, which will help address the revulsion and stereotyping about the disease. "

The 14-day campaign goes beyond its scope by ensuring that the manpower is properly trained and awareness is created which would help in early detection. An approach that is necessary given that leprosy poses some unique challenges when it comes to its detection and elimination.

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