Goal:
Eradicate leprosy world-wide
Phase 1:
Building the Model
Working with communities in Africa, Asia and Latin America, we will prove that leprosy can be eliminated over a 5-year period.
Phase 2:
Global Rollout
Using the data collected and models developed in Phase 1, we will implement the learnings in all regions where leprosy exists.
Strategies:
- Reduce infection rates through early detection and treatment
- Ensure compliance of treatment
- Protect high risk groups
- Increase access to health care to prevent disease
Objectives:
- Detect new cases of leprosy in defined communities
- Ensure compliance of treatment in all patients who are on Multi Drug Therapy (MDT)
- Trace household and other contacts of index leprosy patients and administer chemoprophylaxis
Methodology:
In 4 leprosy endemic countries, across 3 continents, 8 communities will be selected. Total population in Phase 1, across these site will be approximately 1 million people.
The activities will be carried out by using Community Volunteers selected from the populations that are chosen. The activities will be monitored by a supervisor. Both the Community Volunteer and the Supervisor will work closely with the local government health staff who are implementing the leprosy program. The Community Volunteer and the Supervisor will collect and maintain data for the project.
Locations of Phase 1:
Activities:
Over a 5-year period, the specific communities will be involved with:
Eradication means 0 new cases.
Outcome Measures
Baseline Data
At the beginning of the project, baseline data relating to the demographic details of each site will be captured through the first door to door survey
Annual New Case Detection Rate (ANCDR)
= # new cases / population of 100 000
Compliance Rate for MDT
= Percentage of patients who completed MDT within the prescribed time
BCG Coverage
Secondary Data
- Prevalence Rates,
- Multi bacillary proportion,
- Child rate,
- Grade 2 Disability rate among new cases,
- Grade 2 Disability among children and relapses
Contact Tracing and Chemoprophylaxis Coverage =
- Percentage of enumerated contacts traced and examined
- Percentage of new cases identified during contact tracing
- Percentage of chemoprophylaxis given to eligible contacts
- Percentage of contacts who received chemoprophylaxis developing leprosy
- Percentage of contacts who refused chemoprophylaxis and developed leprosy
Hard Questions:
overcoming barriers
1: Return on investment
We estimate the cost of Phase 1 to be €2.5 million. The cost of Phase 2, once the model is proven, will be shared among a range of partners. The Mission to End Leprosy is positioned to raise the initial €2.5 million.
The ROI on that investment is high. It will impact about 1 million people living in communities affected by leprosy who will receive health screening diagnosis, treatment and ongoing care over the 5-year test period. The annual cost per person is 50¢ per person per year.
2: What about our commitment to research through R2STOP?
Research is core to eradication. Research will continue, providing scientific leadership to our overall concept. Insights and evidence-based learnings will be implemented into the overall model of detection, treatment and care.
3: What about caring for people living with the effects of leprosy?
As a partner with many organizations that care for people affected by leprosy, we will continue to care for people suffering the effects of leprosy. In addition, people identified in test regions of high incidence will be treated and cared for.
4: What obstacles will we face?
We anticipate the WHO will continue to speak about leprosy as being eliminated. This is based on unreliable statistics. We are prepared to brief advocates, donors and supporters to understand the real issues.
