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1 June, 2019 00:00 00 AM

Why adequate budget imperative for beating leprosy?

The capacity of those working at the field level for health and leprosy eradication should be increased through regular training so that they can work better
Md. Sazedul Islam
Why adequate budget imperative for beating leprosy?

Leprosy continues to pose serious health and other problems in the country although it is curable and–if diagnosed on time-disabilities resulting from this disease can be prevented. Leprosy is one of the oldest diseases and people with the condition, and their family members, have been despised and abandoned. People still suffer multiple forms of discrimination, including denial of access to work, education or community life.

If steps are taken up to identify leprosy cases in every upazila of the country in early stage, then anti-leprosy drive would go speedily. But due to lack of necessary funds, anti-leprosy activities are being hampered. Early case detection is very important in leprosy elimination programme. Leprosy is such a disease for which initiative to detect new cases has to be taken. Those found to be affected show their negligence to take treatment voluntarily for various reasons. If initiative is not taken to detect new cases and bring them under treatment timely, the goal of eradicating leprosy will not be achieved.        

Aside from a possible disability, later detection also increases the likelihood of leprosy spreading throughout a community. Multi-drug therapy makes people non-infectious after just two weeks of treatment, and so early detection can reduce the number of cases of leprosy in a region.

There are components such as training, smooth supply of Multi-drug therapy (MDT) drugs, early case detection, monitoring, launching awareness campaign, follow-up, carrying out regular contact survey, and skin camp for eradicating the disease. A lot of money is needed for performing those tasks, but these are being hampered reportedly due to lack of necessary funds.

There was inadequate allocation for leprosy eradication in the past, but adequate money is needed to make Bangladesh leprosy free, said Jiptha Boiragee, programme support coordinator of TLMI-B. He suggested increasing financial allocation in the next national budget in the interest of leprosy eradication programme.

According to The Leprosy Mission International-Bangladesh (TLMI-B), annually on an average 4000 new leprosy cases are detected in the country in the recent years. About 10 percent of them later turn disabled for their failure to take timely and proper treatment.

The disease is an infection caused by slow-growing bacteria called Mycobacterium leprae. However, if left untreated, it can affect the nerves, skin, eyes, and lining of the nose (nasal mucosa). The nerve damage can result in crippling of hands and feet, paralysis, and blindness, said TLMI-B.

We need to make leprosy free society where there is no new leprosy cases and all the needs of existing leprosy affected persons having been fully met. It is needed to reduce stigma in the community against leprosy, provide high quality service for all persons affected by leprosy, and integrate leprosy in the integrated health care delivery set-up for provision of quality services.

It is important to hold regular contact survey aimed at  finding out leprosy affected people in an area. Besides, it is important to pursue follow-up, and hold regular monitoring on the activities of leprosy elimination programme centrally.

The capacity of those working at the field level for health and leprosy eradication should be increased through regular training so that they can work better. Skill of the medical officers on leprosy complications especially reaction management should be enhanced through training.

But the matters, mentioned above, are being hampered due to scarcity of money, said the development activists working in the sector.     

Field visit and awareness raising activities by Tuberculosis Leprosy Control Assistants (TLCAs) and Programme Organizers (POs) are being disrupted for funds scarcity. They also failed to do other relevant works for lack of money. TLCAs and POs need necessary training on leprosy and to participate in awareness raising activities.

It is needed to raise the awareness levels of early signs of leprosy, ensure access to leprosy services and skills of health-care staff in diagnosing leprosy.

Ensuring availability of MDT drugs and their proper distribution at the community level is essential. Otherwise, all the efforts of case finding, diagnosis, classification and treatment are rendered meaningless.

There is no alternative to eradicating the disease as it continues to inflict sufferings on our people. But scarcity of money, needed for fighting the disease, is hindering our desired dream of making a leprosy-free Bangladesh. If there were adequate financial allocation in the budget for the leprosy control, leprosy case detection and other related activities would have been done more smoothly, preventing the chance of disability caused by leprosy.

International assistance to leprosy control programme in Bangladesh is decreasing gradually. It is a matter of concern that leprosy elimination programme is being slowed down at the field level due to lack of necessary funds and trained employees. Few NGOs, working in the field with their limited resources amid dwindling of foreign funds, find it tough to handle the task.

The government should come up with necessary steps, including allocating more funds for the programme, said sources.

If leprosy does not get adequate attention in the budget, it will continue to cause sufferings. It is hoped that the government, taking the matter into consideration, would attach due importance to the issue in the next budget.

The Bangkok Declaration, which was adopted at the International Leprosy Summit in 2013 in Bangkok, Thailand, called for reaffirming political commitment, enhancing financial allocations and including persons affected by leprosy.

The Global Leprosy Strategy 2016–2020 aims at accelerating action towards a leprosy-free world. The strategy aims at early detection of leprosy disease and prompt treatment to prevent disability and reduce transmission of infection in the community.

The WHO priority to promote early detection and to monitor this through measuring disability in new case detection is a vital component to evaluate enhanced initiatives designed to reduce transmission.

Made as per the WHO’s guideline, the Leprosy Control Strategy (2016-2020) of Bangladesh called for accelerating towards a leprosy-free Bangladesh. It stressed on stopping leprosy and its complications, early case detection before visible disabilities occur, and ensuring adequate resources.       

If we talk about the Strategy, Bangladesh is bound to take necessary steps for a leprosy-free country. Hence, Bangladesh must allocate adequate funds in the budget so that the Strategy’s objectives are fulfilled smoothly. The mass media should highlight the issue for drawing attention to the policymakers.

Leprosy continues to create social and other problems, resulting in human rights violation of a large number of our people. Hence the issue deserves proper attention.   

Article 1 of the Universal Declaration of Human Rights states: “All human beings are born free and equal in dignity and rights.” This includes every person affected by leprosy.

Solving the leprosy issue will help us in realizing a society where the fundamental rights and dignity of every human being is recognized and enjoyed by its citizens including persons with leprosy and disabilities.

We should let people know that this is not only a cause of injustice against leprosy victims, but also a major hindrance to overall development. If we prevent a large number of people from relishing their rights, deny their development, and refuse to recognize their contribution, we cannot achieve our national progress.

It is hoped that the leprosy issue would get its due attention in the next budget in greater interest of the nation. Any negligence, in this regard, will not augur well for us.    

The writer, a freelancer, can be reached at sissabuj@yahoo.com



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Editor : M. Shamsur Rahman
Published by the Editor on behalf of Independent Publications Limited at Media Printers, 446/H, Tejgaon I/A, Dhaka-1215.
Editorial, News & Commercial Offices : Beximco Media Complex, 149-150 Tejgaon I/A, Dhaka-1208, Bangladesh. GPO Box No. 934, Dhaka-1000.

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