Report No. 256
D. Preventive and Curative Treatments
2.4.1 Prior to its earliest known cure, there was no scientifically established treatment for Leprosy. On account of the lack of a cure, isolation of the patient into asylums and Leprosy colonies was considered to be the only measure for the containment of the disease from spreading onto the healthy population.36 Later on, with the introduction of Dapsone as the earliest known cure, Leprosy control programs took the form of Survey, Education and Treatment ("SET") strategy model, comprising house-to-house surveys for case detection, treatment in out-patient clinics, and health education.37
However, on account of the reluctance of people to cooperate with household surveys, and their hesitation to attend Leprosy clinics due to the prevailing ostracism against the disease, it became difficult for Persons affected by Leprosy to get treated with Dapsone in the initial years.38 In addition, Persons affected by Leprosy who did get treated with Dapsone, in some instances, developed resistance to the drug and therefore could not benefit from the treatment.39
36. Leprosy: The Facts, Myth and Treatment of Disease (n 9).
37. Report of the Working Group on Disease Burden for the 12th Five Year Plan, Planning Commission, Government of India (2011), available at
<http://planningcommission.gov.in/aboutus/committee/wrkgrp12/health/WG_3_1communicable.pdf>
accessed on 24th January, 2014.
38. Navin Chawla (n 7).
39. Navin Chawla (n 7).
2.4.2 Although Leprosy is the cause of irreversible disabilities,40 with advances in science and technology in the field of Leprosy treatment during the last three decades, it is now a completely curable disease that can be rendered non-infectious in the initial stages of the treatment itself. The treatment that has made it possible to cure Leprosy is the process of Multi-Drug Therapy ("MDT"), which was first recommended by the WHO in early 1980s after over 40 years of research and testing.41
Under MDT, powerful drugs such as Rifamipicin, Clofazimine and others in combination with Dapsone, are administered to the affected person to effectively fight the Leprosy bacillus. Over the past two decades, more than 15 million Persons affected by Leprosy are said to have been cured under MDT.42
40. Navin Chawla (n 7).
41. Shigeki Sakamoto (n 10).
42. Report by the Nippon Foundation and Sasakawa Memorial Health Foundation (n 12).
2.4.3 The MDT regimen requires regularity, supervision and continuity to be effective. The regimens are worked out on the basis of whether a particular case involves paucibacillary (very few number of bacilli), which requires a prescribed regimen for about six months, or multibacillary (very large number of bacilli), which requires a prescribed regimen of about one year on an average. After its first dose itself, MDT kills 99.9% of the Leprosy bacteria that cause the disease, thereby rendering Persons affected by Leprosy non-contagious and eliminating the need for the segregation of such persons along with their family members.43
MDT has been used to treat patients in India for the past two decades, and has been instrumental in substantially reducing the incidence of Leprosy among Indians, especially during the 1985-2005 period.44 An early detection of the disease along with its immediate treatment via MDT can save infected persons from irreversible deformities.45 After completing a full course of treatment through MDT, a relapse of the disease in previously affected persons is very rare.46
43. Shigeki Sakamoto (n 10); See also Eighth Report of the WHO Expert Committee on Leprosy, WHO Technical Report Series (2012), available at
<http://www.searo.who.int/entity/global_leprosy_programme/publications/8th_expert_comm_2012.pdf>,
accessed on 24th January, 2014; Report of the tenth meeting of the WHO Technical Advisory Group on Leprosy Control, WHO Regional Office for South-East Asia (2009), available at
<http://www.searo.who.int/entity/global_leprosy_programme/publications/10th_tag_meeting_2009.pdf>,
accessed on 24th January, 2014.
44. Report of the Working Group on Disease Burden (n 37)
45. Hundred and Thirty-First Report on the 'Petition Praying for the Integration and Empowerment of People Affected by Leprosy', Rajya Sabha Committee on Petitions (2008) ("131st Report on Leprosy").
46. Enhanced Global Strategy for Further Reducing the Disease Burden Due to Leprosy (n 16).
2.4.4 In addition to treatment under MDT, reconstruction surgery ("RCS") is also performed on the Persons affected by Leprosy for the correction of disability of hands, feet and eyes caused on account of the disease.47 The Government of India has undertaken programmes to provide free-of-cost treatment to Persons affected by Leprosy through MDT and has also introduced subsidies and compensation schemes for RCS for such persons.48 Meanwhile, the search is on for newer and more effective methods of treatment of Leprosy through vaccination and prophylaxis.
47. 131st Report on Leprosy (n 45).
48. 131st Report on Leprosy (n 45).
2.4.5 As per several surveys and studies conducted on Persons affected by Leprosy, it has been noted that a major obstacle to the uplift of the status of Persons affected by Leprosy is the social stigma associated with Leprosy.49 Persons suffering from the early stages of the disease are dissuaded from approaching a doctor, on account of fear of ostracisation and isolation.50
The main reason for the stigma and discrimination against Persons affected by Leprosy has been the disabling and disfiguring nature of Leprosy that goes against the aesthetic notion of physical beauty that prevails in society.51 The deformities of Persons affected by Leprosy have also been traditionally considered to cause repugnance.52
Further, in the absence of any understanding about the cause and cure of Leprosy for many decades, the Persons affected by Leprosy were viewed, in a number of societies, as objects of divine punishment where the disease was considered as a visitation of past sins, requiring the out casting of such persons.53 In many spheres of life the world over including in India, the process of out-casting of Persons affected by Leprosy continues to take place, although the scale of such process has considerably diminished in light of the growing awareness regarding the disease.
49. Hundred and Thirty-Eight Report on the 'Action Taken by Government on the Observations/Recommendations contained in its Hundred and Thirty-First Report on Petition Praying for the Integration and Empowerment of People Affected by Leprosy', Rajya Sabha Committee on Petitions (2010) ("138th Report on Leprosy").
50. 138th Report on Leprosy.
51. Navin Chawla (n 7).
52. Navin Chawla (n 7).
53. Navin Chawla (n 7).
2.4.5 In light of the large number of fresh cases in India, especially post-2005, an early detection of Leprosy is the need of the hour to prevent Persons affected by Leprosy from exhibiting physical deformities. To address this issue, the law and policy in India needs to adapt to the growing needs of the Persons affected by Leprosy and remove provisions within its framework that discriminate and isolate such persons. In this context, several attempts have already been made to address the cause of Persons affected by Leprosy that shall be discussed in the next chapter.
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