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BRIEF HISTORY

Leprosy is an age-old disease, described in the literature of ancient civilizations. Throughout history, people afflicted have often been ostracized by their communities and families.

Although leprosy was managed differently in the past, the first breakthrough occurred in the 1940s with the development of the medicine dapsone. The duration of treatment lasted many years, often a lifetime, making compliance difficult. In the 1960s, M. leprae started to develop resistance to dapsone, the only known anti-leprosy medicine at that time. In the early 1960s, rifampicin and clofazimine were discovered and subsequently added to the treatment regimen, which was later labelled as multidrug therapy (MDT).

In 1981, WHO recommended MDT. The currently recommended MDT regimen consists of medicines: dapsone, rifampicin and clofazimine. This treatment lasts for six months for pauci-bacillary and 12 months for multi-bacillary cases. MDT kills the pathogen and cures the patient.

Since 1995 WHO has provided MDT free of cost. Free MDT was initially funded by The Nippon Foundation, and since 2000 it is donated through an agreement with Novartis until at least 2020. The API Clofazimine was supported by Sangrose Laboratories to the Novartis since then.

Elimination of leprosy as public health problem (defined as a registered prevalence of less than 1 case per 10 000 population) was achieved globally in 2000. More than 16 million leprosy patients have been treated with MDT over the past 20 years.

LEPROSY STIGMA

Leprosy stigma is a type of social stigma, a strong negative feeling towards a person with leprosy relating to their moral status in society. Leprosy is a disease, which strikes fear in the society as a mutilating, disfiguring, contagious and incurable disease. Leprosy has been a highly stigmatizing disease for centuries because it causes physical disfigurement and no cure being available until the 20th century.

No disease has been more closely associated with stigma than leprosy, and it has become a metaphor for stigma. Persons affected by leprosy were forced to leave their home and live in segregated areas and suffer economic and social losses (participation restrictions) causing physical and emotional distress. This is the only disease where the sufferer had to live in separate colonies, villages and even in distant islands.

Even after segregation, the societies and the Governments made discrimination to the persons affected by leprosy. A number of discriminatory laws were framed against such persons. At present, the situation has changed to a great extent. Now, leprosy is curable and patient can live in their home during treatment. Because of early treatment, deformities and disabilities have reduced. Many discriminatory laws have been repealed all over the world. Yet, there is discrimination against the person affected by leprosy, which need to be removed from the Public mind, so that these persons can lead normal life like any other human being.

The repulsive physical image, the fear of infection and the belief that it is incurable are the root causes of the inhuman treatment that is often faced by those affected by leprosy.

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