Battling leprosy with higher budgetary support

Leprosy seemed to be a less important issue in the country. Due to outbreak of Covid-19, leprosy has reportedly lost its more importance. Bangladesh's aim to achieve the leprosy-free country target seemed uncertain due to continued negligence of concerned policymaking agencies to the leprosy issue though there was a clear-cut directive from Prime Minister Sheikh Hasina to free the country from leprosy by 2030.
Different positive social changes took place in the country, but the leprosy issue failed to get its due attention. Though a large portion of leprosy victims, disabled by leprosy, have become victim of socio-economic deprivation, National Leprosy Elimination Programme (NLEP) is running with an inadequate budget. NLEP's activities are facing disruption due to this factor.
There was average financial allocation of Tk. 4.5 million to 5.0 million (45 lakh to 50 lakh) by the government for the anti-leprosy programme every year in the last five years including the current one. But due to outbreak of Coronavirus anti-leprosy activities by the government remained almost suspended across the country in the last two years.
Rights activists working in the leprosy sector, including officials of NLEP, observed that the amount for anti-leprosy programme was inadequate.
Leprosy is a national problem, but it is yet to get priority to the concerned policymakers. Hence, adequate financial allocation has not been made for addressing the leprosy issue.
Leprosy is one of the oldest diseases in the world. People with leprosy generally suffer multiple forms of discrimination. 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.
If steps are taken up to identify leprosy cases in every upazila of the country in early stage, then the 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 the leprosy eradication programme. If an 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.
For eradicating leprosy, various activities such as training, advocacy, 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 are needed to be done. But these are being hampered mainly due to lack of necessary funds.
Due to lack of a regular survey, initial detection of leprosy patients is being hampered, creating a problem with checking the spread of leprosy disease.
Adequate money was needed to make Bangladesh leprosy free, said Jiptha Boiragee, programme support coordinator of The Leprosy Mission International-Bangladesh (TLMI-B). He suggested increasing financial allocation in the next national budget for the sake of leprosy eradication. Skill development activities of physicians and employees are being hampered because of the budget crunch.
NGOs are detecting more leprosy cases in their working areas and the affected people are getting the health services offered by the government, he said.
According to TLMI-B, annually on an average 3500-4000 new leprosy cases were detected in the country in the recent years. About 10 per cent of them later turned 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, according to TLMI-B.
It is important to hold a 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 the leprosy eradication 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 those were 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 Organisers (POs) are being disrupted for a fund shortage. They also failed to do other relevant work 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 about early signs of leprosy, ensure access to leprosy services and skills of health-care staff in diagnosing the disease.
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 building a leprosy-free Bangladesh.
NGOs are facing a financial crisis as international assistance to the leprosy control programme in Bangladesh is decreasing gradually. It is a matter of concern that the leprosy eradication programme is slowing down at the field level due to lack of necessary funds and trained employees. Under the circumstances, if the government does not come up with necessary steps, the leprosy situation may aggravate.
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.
Made as per the World Health Organization (WHO) guideline, the Leprosy Control Strategy (2016-2020) of Bangladesh called for accelerating work towards a leprosy-free Bangladesh. It stressed 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 required money in the next budget so that the strategy's objectives are fulfilled smoothly.