M A I N   N E W S

Leprosy eradication still a far cry
Aditi Tandon
Tribune News Service

New Delhi, January 29
India’s leprosy elimination targets look grim. If performance indicators under the National Rural Health Mission (NRHM) are anything to go by, the Eleventh Year Plan target of eliminating leprosy and reducing its prevalence rate to less than one per 10,000 remains to be achieved.

Anti-Leprosy Day, January 31, marks the death anniversary of Mahatma Gandhi. Among states with leprosy prevalence rate of more than one per 10,000 are seemingly empowered ones like Chandigarh and Delhi, which are bracketed in this category with Bihar and Jharkhand. Most recent audit findings of the National Leprosy Elimination Programme (NLEP) under the NRHM further confirm Orissa’s position as the most leprosy-vulnerable state with a prevalence rate of over one per 10,000 in 16 of its 30 districts and 94 of its 314 blocks.

Dissection of National Rural Health Mission performance targets shows that total cases of leprosy as well as new cases remains high, especially in the study period that stretched from 2005 to 2008 to get a broad idea of how healthcare goals were doing. Between 2007 and 2008, new leprosy cases increased in Bihar, Chattisgarh, Dadra and Nagar Haveli, Himachal Pradesh, Karnataka, Maharashtra, Mizoram, Tripura, Tamil Nadu and Madhya Pradesh, finds the latest CAG report.

What’s most worrisome is the dearth of medication at several surveyed centres. Medicines were not available in 29 community health centres and 82 primary health centres test checked by audit teams in Bihar, Haryana and Punjab. The Ministry of Health, for its part, says the country had achieved leprosy prevalence rate of less than one per 10,000 at the national level in 2005 - a goal earlier set by the National Health Policy, 2002. It also adds in a reply to the auditors’ observations that as of March 31, 2009, of the 35 states and UTs, only Bihar, Chattisgarh and Dadra and Nagar Haveli had a prevalence rate of more than one per 10,000.Out of 630 districts, data shows that 510 have achieved elimination status. Among those still struggling, the concern of availability of multi-drug therapy remains. These include Bihar, Haryana, Punjab and Manipur, where supply of medicine has been found wanting, warranting adequate supplies from the government. But the biggest drawback in the elimination programme is the inability of certain state governments to maintain a two-month buffer stock in all districts and all primary health centres.For the emergence of new cases, the government has an answer. “Under National Leprosy Elimination Programme, more emphasis was given to detection of new cases and completion of their treatment. Increase in the number of new leprosy cases suggests that states are now making efforts to detect new cases at an early stage so that they don’t have to suffer the consequences,” the government replied to auditors’ observations on the NLEP.