RI urged to fight leprosy in provinces

Tb. Arie Rukmantara, The Jakarta Post/Jakarta

After successfully reducing the prevalence of leprosy in the country, the Indonesian government and people should now concentrate on eliminating the disease in several provinces, the World Health Organization suggests.

WHO regional advisor for leprosy and other priority diseases Derek Lobo said by the year 2000, Indonesia was among the 108 countries that had achieved the goal of reducing the national prevalence rate, leaving only nine countries with a high prevalence at present.

"We are now aiming to achieve the elimination at the sub- national level: at the provincial and district levels," Lobo said here on Thursday.

The criteria set by the WHO for a successful fight against leprosy is a prevalence of less than one case per 10,000 population.

Lobo said there were 12 Indonesian provinces, mostly located in the eastern part of the archipelago, that had failed to reach the target so far.

Leprosy is a chronic disease caused by Mycrobacterium leprae bacillus, which is transmitted via droplets, from the nose and mouth during close and frequent contact with untreated cases.

Although it is not highly infectious and is curable using multi-drug therapy (MDT), the disease can progressively and permanently damage the skin, nerves, limbs and eyes, if untreated.

Lobo said since the introduction of multi-drug treatment (MDT) in the country about 20 years ago, more than 300 people have been cured.

But in the last three to four years WHO has found about 15,000 to 16,000 new cases every year in Indonesia.

"We have every hope that Indonesia can achieve provincial level elimination within the next one or two years and go further to district elimination maybe by 2010," he said.

To support the goal, a senior WHO Indonesia official Firdosi R. Mehta said the world body would hold a Leprosy Elimination Monitoring (LEM) exercise to help regional administrations identify problems in eliminating the disease.

"Most communicable diseases or syndromes, such as HIV/AIDS, tuberculosis and malaria, are mainly a problem in the eastern part of Indonesia. Mostly this is related to inaccessibility to health services and basically the health services are not as developed as on Java," he said.

Visiting WHO Goodwill ambassador for leprosy elimination Yohei Sasakawa stressed that aside from curing leprosy patients, there should be efforts to erase discrimination against former leprosy patients.

"Today leprosy is a curable disease. Anywhere in Indonesia treatment is provided free of charge and therefore it is a big mistake to discriminate against people or their family members who are affected by leprosy," he said.

Sasakawa, who chairs the Nippon and Sasakawa Foundations that have donated over $400 million to the global fight to eliminate leprosy since 1974, said discrimination against lepers was categorized as a human rights violation.

"They cannot be reintegrated or rehabilitated, they cannot marry or cannot go to school," he said. "That is a serious human rights violation."

The 56th United Nations Sub-Commission on the Promotion and Protection of Human Rights adopted last year a resolution entitled: Discrimination against leprosy victims and their families, to give more dignity to leprosy patients.

Sasakawa suggested that all members of the society help former leprosy patients through education livelihood programs.

"People could start various programs such as micro credit, so that former leprosy patients could start their own business and provide scholarships for their children," he said.