Why this website was created and how it might develop
As reflected by the first entries the initial purpose of this website was to be transparent about the follow-up to the Foundation's spontaneous commitment for a new study initiative, made at the Leprosy Congress 2008 in Hyderabad. A complex field like working towards a leprosy-free world is necessarily characterized by a vast variety of opinions and approaches, partly complementary, partly conflictive. This is not a problem as long a certain debate remains factual and focussed on a specific issue, avoiding prejudice and general reproaches. In the current phase of anti-leprosy work, where the net has to be woven finer to get hold of the meanwhile rare catch, nothing is so important like joining forces and sharing insights in order to build synergies.
This is why it is desirable that this website might become more than just a documentation of the activities in the context of the Foundation's new global leprosy study initiative. If it is true that there is a widespread consensus that better knowledge about successful anti-leprosy practices is needed, but very different ideas exist what kind of knowledge we should strive for, then it should be a valuable opportunity to use this website to identify commonalities and start joint projects.
On what basic assumptions the website's content is based
Sometimes one only assumes that the basic assumptions underlying one's statement are shared -- and this leads to major misunderstandings. Therefore comments and contributions to this website should mention if they are not based on the following core assumptions:
» leprosy cases need to be detected as early as possible to be treated
with standard multi-drug treatment
» diagnosis and treatment skills need to be established and maintained
within the normal public health system
» diseminating the knowledge that leprosy is curable and treatment is for free
is crucial to overcome stigma
Why the “e-word” shouldn’t be a problem
This website is dedicated to the overall goal shared by all interested players probably without any exception: to reach a world free of leprosy as soon as possible. However, as the transmission mechanism is still quite unclear and the incubation period rather long, it remains a dream to measure whether transmission really is interrupted in a geographical area – or whether the disease will spread again once the pressure of good quality public health service dwindles.
Somehow it doesn’t matter how exactly “elimination” is defined (see as a publication often referred to: Dowdle WR, The principles of disease elimination and eradication, Suppl #2 WHO Bulletin 76, 1998, 22-25) and at what level leprosy isn’t regarded a major public health problem anymore.
Given the existence of a simple, highly effective and free-of-charge treatment (multi-drug therapy, donated by the manufacturer) and given the risk of very significant impairments and disabilities as a result of delayed treatment, it is an obvious task to identify best practices of maintaining – with modest resources – a high level of leprosy related skills in a public health system or to establish this were it was not possible, yet.
What has been best practice in times of higher prevalence can, but doesn't necessarily remain best practice in today's times of a very rare disease. Therefore any opportunity needs to be taken to increase the shared understanding of what works efficiently under various operational conditions to get closer to a world where transmission of leprosy is not a real issue anymore – whatever main benchmark we are referring to...
Novartis Foundation for Sustainable Development
CHBS, WRO-1002.11.64
Schwarzwaldallee 215
CH-4058 Basel
Switzerland
Phone: +41 61 697 71200
Fax: +41 61 697 7104
Email: info@novartisfoundation.org
