Preliminary building blocks for multi-stakeholder development of a leprosy elimination investment case: proceedings of an expert consultation

摘要

Leprosy is still a significant health problem in many countries. In 2017, 79 nations reported100 or more new cases of leprosy.1 Between 1985 and 2017, a sharp decline was observed inthe reported prevalence of leprosy from 5·2 to 0·21 million.1 Multidrug therapy (MDT) hascontributed substantially to this decline, with over 15 million people cured from leprosy sinceits introduction in 1982. MDT is provided free of cost worldwide by Novartis, and thedistribution is managed by WHO. However, global new case detection has remained more orless stagnant in the last 10 years. The substantial proportion of child cases among new casesindicates that the transmission of M. leprae is still ongoing in many countries and areas. Amajor reason is that M. leprae is a slow growing bacterium and leprosy has an averageincubation period of about 5 years.2,3 Persons incubating the disease are infectious at somepoint during that period, which is likely a major reason why treatment of symptomatic caseshas had so little impact on the incidence of leprosy. A second reason is that the activitiesrecommended by the WHO’s Global Leprosy Strategy, such as early detection, contactexamination and prompt treatment, were often implemented inadequately.