Leprosy in India

Leprosy currently affects approximately a quarter of a million people throughout the world, with majority of these cases being reported from India.^[1]

India is a signatory of United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). India is currently running one of the largest leprosy eradication program in the world, the National Leprosy Eradication Program (NLEP). Still, 1.2 to 1.3 hundred thousand new cases of leprosy reported every year, 58% of the total amount of new cases reported every year. Since children are most susceptible to leprosy, they face worse discrimination and ostracisation from childhood, including the denial of basic rights and medical care.

Transmission, treatment and disability

Leprosy is one of the least infectious diseases as nearly everyone has some measure of natural resistance against it.^[2] Nevertheless, stigma against the disease due to its disfigurement causes its victims to be isolated and shunned. Leprosy is also the leading cause of permanent disability in the world and is primarily a disease of the poor.

The disease is now readily treatable with multi-drug therapy, which combines three drugs to kill the pathogen and cure the victim.^[3] Disability and disfigurement can be avoided if the disease is treated early. Unfortunately, individuals with leprosy are still shunned, isolated, and stigmatised, leading to the fear of leprosy being worse than the disease itself.^[4]

History

India is considered the point of origin of leprosy with skeletal evidence of the disease dating to 2000 B.C.^[5] The disease is thought to have spread through trade and war to other parts of Asia, the Middle East, North Africa, and later Europe and the Americas. In ancient Indian society, individuals suffering from leprosy were alienated because the disease was chronic, contagious, resulted in disfigurement, had no cure at the time, and was associated with sin.^[6] In colonial India, the government enacted the Leprosy Act of 1898, which institutionalised leprosy victims and separated them based on gender to prevent reproduction. These laws mainly affected the poor because those who were self-sufficient were not obligated to be isolated or seek medical treatment. In the 20th century, even when drugs to treat leprosy became available and more knowledge was gained about the disease, the scourge of leprosy remains a persistent and widespread health problem throughout all regions of the country.

Legal discrimination

The historical legacy and societal stigma toward leprosy are evidenced by various laws containing discriminatory clauses against leprosy victims. Laws in the states of Chhattisgarh, Rajasthan, Madhya Pradesh, Andhra Pradesh, and Orissa prohibit leprosy patients from running in local elections.^[7] These laws have been supported by the national government, as evidenced when India's Supreme Court upheld a ruling by the state of Orissa prohibiting leprosy patients from participating in local elections.

Other laws include the Motor Vehicle Act of 1939 which restricts leprosy patients from obtaining a driving license and the Indian Rail Act of 1990 which prohibits leprosy patients from traveling by train.^[8]

Many of these laws were written before the development of multi-drug therapy (MDT) and they have not been updated since. For example, almost all of the marriage and divorce laws of India consider leprosy as grounds for divorce with the Special Marriage Act of 1954 declaring leprosy "incurable." These laws do not reflect the current understanding of leprosy.

See also

• Baba Amte
• Gerhard Fischer (diplomat)

References

External links

• WHO Leprosy Factsheet
• Laws in India Criminalise Leprosy
• Anandwan