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Leprosy -

Clinton Global Initiative Video on Neglected Tropical Diseases
This hour-long talk show with former US president Jimmy Carter, Professor of Microbiology and Tropical Diseases Peter Hotez, and Uganda Director of Health Services, Ministry of Health Sam Zaramba discusses cost-effective measures for eliminating neglected diseases, the threat they pose and the impact they have for developing nations, and viable treatment and control measures.
Kaiser Network

PAHO Communicable Disease Research Program (CDR)
This page offers the user basic information and a variety of resources in the area of research in infectious diseases: mandates, program description, PAHO guides for researchers submitting proposals and reports, links to its WHO counterpart and to the PAHO Research Grants Program as well as to donor institutions and related sites, international awards, announcements of conferences and publications, upcoming events, etc.

10 Facts about Neglected Tropical Diseases
These ten facts provide a basic overview on what constitutes neglected tropical diseases and what is being done to combat them.

Health Surveillance and Disease Prevention and Control at PAHO
This page describes the PAHO Technical Area for Health Surveillance and Disease Prevention and Control(HSD), its mission and objectives, what it does in terms of projects and activities. It contains links to the four technical groups and the Pan American Center under its umbrella. Note: Prior to June 2006, the Area was named Disease Prevention and Control.

PLoS Neglected Tropical Diseases: A Peer-Reviewed Open-Access Journal Published by the Public Library of Science
This free online journal offers articles covering the broad spectrum of neglected diseases, including geohelminths, river blindness, snail fever, Chagas disease, leishmaniasis, filariasis, and other diseases of the poor that are often neglected by health systems, the pharmaceutical industry, and the press.

An Achievable Dream: Eliminating Some Diseases from the Americas
In this speech, PAHO Director Dr. Mirta Roses outlines a set of communicable diseases--vector-borne, zoonotic, viral, bacterial and parasitic--that can be eliminated or significantly reduced by 2015 at the regional, subregional, or national level.
PAHO Director

I can do it myself! Tips for people affected by leprosy who want to prevent disability
This 40-page illustrated booklet, designed for distribution to patients, gives step-by-step, detailed instructions on how persons affected by leprosy (hansen's disease, hanseniasis) can take the necessary steps to prevent disability and avoid and treat wounds in their eyes, hands and feet themselves, thus empowering them to improve the quality of their life and their health.
lep-SelfCareBooklet.doc lep-SelfCareBooklet.pdf

CSP27.R10: Regional Policy and Strategy for Ensuring Quality of Health Care, Including Patient Safety
This resolution from the 27th Pan American Sanitary Conference in 2007 sets forth the PAHO mandate for providing effective, safe, efficient, accessible, appropriate, and satisfactory care for users, recognizing that policies are needed in the health sector that will impact the health care continuum, foster citizen involvement, and promote a culture of quality and safety in health care institution.

Control of Neglected Tropical Diseases (New England Journal of Medicine, 357: 10, September 6, 2007)
The neglected tropical diseases are a group of 13 major disabling conditions that are among the most common chronic infections in the world's poorest people. A blueprint for the control or elimination of the seven most prevalent neglected tropical diseases has been established by a group of private, public, and international organizations working together with pharmaceutical partners and national ministries of health. Through the newly established Global Network for Neglected Tropical Diseases, with updated guidelines for drug administration issued by WHO, partnerships are coordinating their activities in order to launch a more integrated assault on these conditions.

Global Plan to Combat Neglected Tropical Diseases, 2008–2015
The WHO Global Plan to Combat NTDs Global Plan has been formulated according to the following key principles: the right to health; existing health systems as a setting for interventions; a coordinated, multi-disease response by the health system; integration and equity; and intensified control of diseases alongside pro-poor policies. This page contains the executive summary plus a link to the full text.

Tackling Neglected Diseases in Latin America
This page links to two Biomedical Center (BMC) Public Health articles, one a commentary on improving the health of neglected populations in Latin America and the other, an article on prevention, control, and elimination of neglected diseases in the Americas.

Leprosy Detection Rate, 2006
This map (depicted on a PowerPoint slide) shows the detection rate for new leprosy cases in 23 countries of the Americas during the year 2006.

Situation Report: Leprosy in the Americas, 2007
This 11-page report offers data on the current situation of leprosy (Hansen's disease, hanseniasis) in the Americas, with a data table on 26 countries, a map showing detection rates, and sections with country information on Argentina, Brazil, Cuba, Dominican Republic, Ecuador, Haiti, Mexico, Paraguay, Santa Lucía, and Venezuela.

Health discusses actions to eliminate and control Hansen’s disease: National Evaluation & Monitoring Meeting, National Program for the Elimination and Control of Hansen’s Disease (Brasilia, 23–25 July 2007)
The objective of this meeting was to discuss what actions to take to eliminate and control Hansen’s disease in the country by 2010, given that detection data has become the most important indicator for monitoring this endemic disease. This page includes a summary and the agenda plus 19 posters, 16 showing nationales and state data, one on system integration for rehabilitation and disability prevention, and one on data registry.
lep-bra-ms-julho-07.htm lep-bra-ms-julho-07.pdf

Leprosy in Cuba
This PowerPoint presentation of 39 slides describes the current situation of leprosy in Cuba and the efforts being made to detect, treat, and eliminate the disease. It describes how services are organized and offers statistical information and a map showing incidence in the different parts of the country.

A Turning Point 2007: Report of the Global Partners' Meeting on Neglected Tropical Diseases (Geneva, Switzerland, 19-20 April 2007)
An estimated one billion people--one sixth of the world’s population--are infected with one or more neglected tropical diseases. These diseases are largely ancient infectious diseases that thrive in impoverished settings, especially in the heat and humidity of tropical climates. This meeting of 200 key international partners declared to the world that control of these diseases deserves high priority on the global public health agenda and still greater determination to deliver appropriate health care to the millions of poor people in need.

Prevention, control, and elimination of neglected diseases in the Americas: Pathways to integrated, inter-programmatic, inter-sectoral action for health and development
Over 210 million people in the Americas live below the poverty line. These impoverished and marginalized populations are heavily burdened with neglected communicable diseases. These diseases continue to enact a toll, not only on families and communities, but on the economically constrained countries themselves. The purpose of this paper is three fold. First, it focuses on a need for integrated "pro-poor" approaches and policies different from traditional approaches. Second, it outlines the need for a specific strategy for addressing these diseases and offers several entry points in the context of broad public health measures involving multiple sectors. Finally, the paper presents several initiatives from PAHO and other institutions that document the importance of integrated, inter-programmatic, and inter-sectoral approaches. Authors include PAHO experts from different areas and the PAHO Director. (BMC Public Health 2007, 7:6, doi:10.1186/1471-2458-7-6)
BMC Public Health

Leprosy (WHO Fact Sheet No. 101)
This official WHO fact sheet provides basic information on leprosy (Hansen's disease), a chronic disease caused by a bacillus, Mycobacterium leprae, which multiplies very slowly with an incubation period of about five years. Symptoms can take as long as 20 years to appear. It is not highly infectious but is transmitted via droplets, from the nose and mouth, during close and frequent contacts with untreated cases. It mainly affects the skin and nerves; if untreated, there can be progressive and permanent damage to the skin, nerves, limbs, and eyes. Throughout history, the afflicted have often been ostracized by their communities and families. However, today leprosy is a curable disease and treatment provided in the early stages averts disability. With minimal training, leprosy can be easily diagnosed on clinical signs alone; WHO recommends multidrug therapy (MDT) consisting of three drugs: dapsone, rifampicin and clofazimine. This drug combination kills the pathogen and cures the patient. MDT is safe, effective and easily administered under field conditions and is available in convenient monthly calendar blister packs to all patients.

Leprosy (TDR Fact Sheet and Research Resource Page)
This page offers basic information and access to WHO resources for researchers. Leprosy is occasionally known as Hansen’s disease, after Armauer Hansen, the Norwegian physician who first identified the microorganism which causes the disease. Known and dreaded since biblical times because of the severe deformities that can occur, it was considered incurable until as recently as the 1940s. Now elimination has been achieved or is underway in many countries.

Neglected Diseases: The Diseases of Poverty
Neglected Diseases strike populations already cripped by poverty and inequity: women, children, indigenous populations, the poor. This bilingual poster, the text of which appears in both HTML and Word in fact-sheet format, outlines the health and economic impact of Neglected Diseases and the current response in terms of prevention and treatment and intersectoral solutions.
psit-nd-poster.htm psit-nd-poster.doc psit-nd-poster-wha.pdf

The Burden of Neglected Diseases in Latin America and the Caribbean Compared with Some Other Communicable Diseases
This graph makes a case for increased attention to neglected diseases by illustrating their tremendous disease burden as compared to other communicable diseases that receive a higher level of attention from health systems.

Leprosy in Ecuador, 2006
Ecuador was the first country in the Americas to reach the goal of elimination of leprosy as a public-health problem. This nine-page country profile gives a good accounting of the progress made in recent decades as well as current challenges, with a series of illustrative graphs and maps.
lep-ecu.doc lep-ecu.pdf

CD47.R18: Health of the Indigenous Peoples in the Americas
Taking note of the existence of inequities in health and access to health care services that affect more than 45 million indigenous people living in the Americas; and because the United Nations Millennium Declaration cannot be reached unless the specific health needs of excluded populations, such as indigenous peoples, are addressed, this resolution of the 47th PAHO Directing Council in 2006 sets for the mandate to take a multicultural approach to include these groups and work towards greater equity and better health for all.

Consensus Statement on Prevention of Disability (Consensus Development Conference on the Prevention of Disability [POD], Cebu City, Philippines, 13–16 September 2006)
The objectives of the conference were to discuss POD activities in the context of leprosy and other chronic diseases, such as Buruli ulcer, lymphatic filariasis and diabetes; to agree on basic definitions; to agree on a basic, evidence-based approach to POD that is part of routine case management; to agree on the elements of home-based self-care; to agree on methods of monitoring and reporting POD activities; and to agree on priorities for further clinical and operational research in POD. This page contains the executive summary and access to the 9-page statement in PDF, with specific bibliographical references.
lep-consensus-stmt-pod.htm lep-consensus-stmt-pod.doc lep-consensus-stmt-pod.pdf

Global Leprosy Situation, 2006
This 8-page article from the WHO Weekly Epidemiological Record provides an overview of the current situation of leprosy (Hansen's disease) in the world: introduction, data table for endemic countries, leprosy burden, and conclusion.

Global Strategy for Further Reducing the Leprosy Burden and Sustaining Leprosy Control Activities (2006–2010): Operational Guidelines
The Global Strategy for Further Reducing the Leprosy Burden and Sustaining Leprosy Control Activities (2006–2010) has been widely welcomed and endorsed. Its overall goal is to provide access to quality leprosy services for all affected communities following the principles of equity and social justice. The purpose of these Operational Guidelines is to help managers of national health services to implement the new Global Strategy in their own countries. This will be done as they develop detailed policies applicable to their own situation, and revise their National Manual for Leprosy Control. This page offers the executive summary, table of contents, and access to the Guidelines.
lep-global-strat-06-op-gl.htm WHO

Communicable Disease Prevention and Control at PAHO: Aims, Strategies and Lines of Action
This page summarizes the mission, objectives, strategies and lines of action of the PAHO Communicable Disease Unit and describes what it hopes to accomplish through technical cooperation.

Minister of Health Agenor Álvares Receives WHO Ambassador for Leprosy Elimination in Brazil
News report on the official visit of special ambassador Yoshei Sasakawa with the Minister of Health of Brazil, numerous Brazilian health authorities, and representatives of associations of people affected by Hansen’s disease. Highlights include the progress of the national elimination campaign and promotion of the Global Appeal to End Stigma and Discrimination against People Affected by Leprosy, which calls for putting the topic on the UN and national human-rights agenda and further mobilizing society to end the fear and prejudice surrounding the disease.

Eighth Meeting of the WHO Technical Advisory Group on Leprosy Control (Aberdeen, Scotland, 21 April 2006)
The main objective of the meeting was to review the global leprosy situation (report contains tables on same) and discuss key technical issues, including the progress and results of ongoing drug trials. The most important agenda item was to approve the Operational Guidelines. This page contains the full-text meeting report.
lep-tag-8-2006-aberdeen.htm lep-tag-8-2006-aberdeen.pdf

Investing in Global Health: 'Best Buys' and Priorities for Action in Developing Countries
These three new volumes from the World Bank Disease Control Priorities Project--Disease Control Priorities in Developing Countries (2nd ed.), Priorities in Health, and Global Burden of Disease and Risk Factors--are part of an ongoing initiative to provide technical resources to improve the health systems, and ultimately the health of people, in developing countries.
DCP Site

Priorities in Health
Two overarching themes emerge from the extensive research and analyses in this World Bank publication: (1) Current resources can yield substantial health gains if knowledge of cost-effective interventions were applied more fully. (2) Additional resources are needed in low-income countries to minimize the glaring inequities in health care. Increased resources would provide highly-effective interventions, expand research, and extend basic health coverage to more people. WHO contributed to this publication.

Nippon Foundation: A Partner in the Fight against Leprosy (Hansen's Disease)
The Sasakawa Memorial Health Foundation (SMHF), affiliated with the Nippon Foundation of Japan, has been an active partner with WHO in the fight against leprosy (also referred to as Hansen's disease). This page provides details and links to relevant information on the foundation site.
lep-nippon-fdn.htm Nippon Foundation website

Neglected Diseases: Search Page for PAHO and WHO Information
This page contains a list of neglected (primarily tropical) diseases of importance in Latin America and the Caribbean, with links to sites or autosearches with information on them. PAHO is developing a multi-disease approach to the prevention, control, or elimination of the diseases in this area.

Global Appeal to End Stigma and Discrimination against People Affected by Leprosy
Leprosy is among the world's oldest and most dreaded diseases, often resulting in terrible deformity. Patients were abandoned, forced to live in isolation and discriminated against as social outcasts. Though now curable, fear of leprosy remains deep-rooted; ignorance and misunderstanding result in prejudice and discriminatory attitudes that remain firmly implanted as custom and tradition. This landmark document appeals to the UN Commission on Human Rights to governments, and to people all over the world in an effort to mobilize political will and human sensibility to improve the quality of life of people and families affected by leprosy.
Nippon Foundation

Leprosy Cases in Brazil Drop by 24.27% in Two Years
On 26 January 2005 in Brasilia, the President Lula devoted part of his agenda to a meeting with the Movement of Reintegration of People Affected by Hansen’s Disease (MORHAN, the main NGO), attended by representatives of the Ministry of the Health, the National Program to Eliminate Hansen’s Disease and PAHO/WHO (a collaborator in this campaign). The main objective of the meeting was to analyze the tremendous progress made over the past two years in the effort to eliminate Hansen’s disease as a public-health problem, to improvements made to the quality of life of those who have been affected by leprosy, and in initiatives to fight discrimination against those who have the disease.

Leprosy Situation: Region of the Américas, beginning of 2006
This data table shows the regional situation of leprosy in the Americas, per country, organized by prevalence as of end of 2005 and the number of new cases reported in 2005, new MB cases, new cases among women, new cases among children, new grade 2 disability cases, and relapses.
lep-americas-2005.htm lep-americas-2005.pdf

Leprosy Detection Rate 2005
This map shows the leprosy detection rate for 17 countries of Latin America and the Caribbean.
lep-detec-2005.htm lep-detec-2005.pdf

Problem Tree for Leprosy
This problem tree was developed following the situation analysis of leprosy (Hansen's disease / Hanseniasis) in the countries, in accordance with the requirements of the WHO Global Strategy. This 23-slide presentation concentrates on 20 main problem areas that act as obstacles either individually or with others to cause late detection of the disease. The basic scheme is useful for orientation purposes for national and local programs or as a poster and can be used for group presentations when adapted to the national or local context.

Status of Leprosy in the Region of the Americas
This fact sheet describes and illustrates the current situation for leprosy (Hansen's disease) in the Region of the Americas, in a context of eliminating the disease as a public-health problem and the reduction in its incidence resulting from the use of multidrug therapy (MDT). It contains a table with data from the countries and a map showing leprosy prevalence, as well as a summary of current activities and challenges.
lep-americas.htm lep-americas.pdf

Keeping Leprosy Under Control: Caribbean Leprosy Control Managers' Workshop (Georgetown, Guyana, 29 June - 1 July 2005)
This event, focusing on the Caribbean, is co-sponsored by PAHO/WHO, Netherlands Leprosy Relief (NLR), the Caribbean Epidemiology Centre (CAREC), and the Ministry of Health of Guyana. It will provide a situation analysis, discussions on IEC and leprosy campaigns, the issues of tourism, and sensitivity and sustainability topics. Presentations will be made by the Caribbean delegates as well as those from Guyana and Suriname. This page includes an abstract and the summary report.

Global Strategy for Further Reducing the Leprosy Burden and Sustaining Leprosy Control Activities (Plan period: 2006–2010)
The emphasis of the WHO global strategy on leprosy control will remain on providing quality patient care that is equitably distributed, affordable and easily accessible. At the moment, there are no new technical tools or information that warrant any drastic changes in the strategy. However, there is an urgent need to make decisive changes in the organization of leprosy control, in the attitude of health-care providers and beneficiaries, and in the working arrangements between all partners. This page offers the executive summary and a link to the full-text WHO document.

Hospital Fair: Ministry of Health of Brazil Participates in Launching Telemedicine and Virtual Man Projects to Control Leprosy
As a joint Project of the School of Medicine of the University of São Paulo (USP) and PAHO, the Telemedhansen Project uses telemedicine and the Homem Virtual (Virtual Man) as its strategies. The program launches the Homen Virtual as something to which the Brazilian population is entitled with regard the health promotion. This means that the software explaining how Hansen's disease is transmitted and how to identify suspicious spots will be considered public domain. The project involves training physicians, health professionals, and community actors in the use of tools offering assistance and distance learning. This page offers a summary and links to the projects.

Report of the Seventh Meeting of the WHO Technical Advisory Group on the Elimination of Leprosy (4–5 April 2005)
The main objective of this year's TAG meeting was to review and finalise the draft Global Strategy for Further Reducing the Leprosy Burden and Sustaining Leprosy Control Activities: 2006–2010. The large-scale implementation of the Strategic Plan increased the coverage of leprosy control activities and brought many previously undetected cases to health facilities for treatment. The plan will address the remaining challenges and further reduce the global leprosy disease burden. A highlight of this meeting was the presentation by Brazil. Included on this page are the recommendations and access to the full text.
lep-tag-2005.htm WHO

Global Leprosy Situation 2004
This 7-page article from the WHO Weekly Epidemiological Record summarizes the situation of leprosy in the world in 2004, complete with tabulated data by WHO Region and country and with updates of the latest in leprosy elimination.
WHO/WER 80 (13)

Ministry of Health of Brazil Launches 2nd Edition of the Charters of Elimination: Epidemiological Situation of Hansen's Disease among Children under 15
On 28 January 2005, the Brazilian government launched the 2nd edition of the Charters of Elimination, focusing on the epidemiological situation of leprosy (Hansen's disease) among children under the age of 15. The Minister of Health delivered a charter to each of the 27 Brazilian states, which can be accessed via this link on the website of the Secretary of Health Surveillance (MS/SVS).

Leprosy Detection Rate 2004
This map shows the detection rate for leprosy for 11 Latin American and Caribbean countries.
lep-detec-2004.htm lep-detec-2004.pdf

Definitions and Terms in Implementation Research and Health Systems Research
This highly useful guide is a product of the WHO Tropical Disease Research Program project on Intervention Development and Implementation Research (IDE).

Successful Experiences in Disease Control in Brazil Presented at Expoepi (Brasilia, 23-26 November 2004)
The Ministry of Health of Brazil and the Department of Health Surveillance (SVS), with PAHO participating, held the 4th National Exhibit on Successful Experiences in Epidemiology and Disease Prevention and Control (Expoepi). The objectives of the event, the most important in its area in all Brazil, were to exhibit and award actions implemented in the cities and states that had a positive impact on the prevention and control of diseases of importance to public health, by improving the quality of epidemiological surveillance.

Tribute Paid to Doctor Diltor Vladimir Araújo Opromolla, Symbol of the Fight against Hansen's Disease (4th Expoepi, Brasilia, 23 November 2004)
Diltor Vladimir Araújo Opromolla is one of the great names linked to the fight against and control of Hansen's disease (leprosy) in Brazil and throughout the world. In 2004, the Brazilian Ministry of Health paid tribute to Opromolla for his contributions to both the country and the world for the discovery of a cure against Hansen's disease. He has also contributed much in the area of human-resource development. He has also contributed greatly to the fight against prejudice regarding Hansen's disease, which still persists in society. In Expoepi 2004, he received a plaque from PAHO to commemorate his contributions.

Instituto Lauro de Souza Lima (ILSL): PAHO/WHO Collaborating Center for Capacity-Building and Training in Leprosy Control and Research
The Instituto Lauro de Souza Lima, located in Barau, São Paulo, Brazil, is dedicated to strengthening research capacity and training personnel in the area of leprosy control and research, mainly serving the Portuguese-speaking countries. This page summarizes the Center's activities and offers a link to its website.

Regional Core Health Data System - Indicators Glossary
Definition, technical note, type, measure units, categories, and subcategories for each indicator in the Regional Core Health Data System

Ministry of Health of Brazil Launches Instrument to Monitor Leprosy in Each State: The Charters of Elimination
The 21st of October, 2004, was a very special day: the Brazilian government launched its "Charters of Elimination," a powerful instrument for monitoring leprosy elimination. The Minister of Health delivered the letter to each of the 27 states. Along with the summary, this page provides links to the Brazilian website with full details.

CD45.R3: Millennium Development Goals and Health Targets
This resolution from the 45th PAHO Directing Council in 2004 issues a series of mandates to advise countries on what they need to do to meet the United Nations Millennium Development Goals (MDGs).

The Final Push towards Elimination of Leprosy: Strategic Plan 2000–2005
One of the important developments in public health in recent years has been the tremendous progress made in conquering leprosy through the widespread implementation of multidrug therapy (MDT) to cure all patients and to reduce the disease burden in leprosy-endemic countries. This page offers access to the WHO plan, a presentation and newsletter article on the elimination drive, Brazilian efforts to eliminate the disease, and the PAHO and WHO main leprosy pages.

Multidrug Therapy against Leprosy: Development and Implementation over the Past 25 Years
Multidrug Therapy (MDT) has transformed leprosy from being a scourge of humankind into a curable disease. However, it remains a neglected disease, despite the efforts of countries like Brazil in the area of all-out elimination. This comprehensive report outlines the many lessons that have been learned and great progress achieved, both in research and in leprosy control. This page offers a summary and access to the full-text report on the WHO website.

Bauru Consensus for Validating Leprosy Diagnoses in Endemic States in Brazil
This consensus is a collaborative effort of PAHO-Brazil, the Secretary of Health Surveillance, Ministry of Health, and the Lauro de Souza Lima Institute, with the objective of validating the leprosy diagnostic procedures for new cases. The exercise will be carried out in the 23 endemic states during August 2004. This page offers access to a summary, the full-text document (with forms and instruments), and other useful links on leprosy elimination in Brazil.

Self-Instruction Course on Health Situation Analysis for Endemic Hansen's Disease (Leprosy)
This manual is the result of a joint effort by the Brazilian Ministry of Health and PAHO. The instructional material is composed of self-teaching units on practices and instruments currently being used to measure progress made in eliminating leprosy. The course is aimed at those interested in learning to use public-domain tools developed to analyze the health situation and to plan prevention activities. The purpose is to help improve program performance. This page offers a summary and the full-text instructional module in Portuguese.

Steroid prophylaxis for prevention of nerve function impairment in leprosy: randomised placebo controlled trial (TRIPOD 1)
This online article published in the British Medical Journal is recommended by the PAHO Leprosy Team. It deals with an Asian project on multibacilliary leprosy, the objective of which was to determine whether the addition of low-dose prednisolone to multidrug treatment can prevent reaction and nerve function impairment in leprosy. (To enable an easy search, the user can enter the number bmj.38107.645926.AE in the standard search box on the menu bar across the heading of the BMJ site.)

President Lula wants to eliminate leprosy from Brazil by 2005.
In the presence of hundreds of cured leprosy patients, public autorities, and MORHAN volunteers, President Lula launched the National Plan to Eliminate Hanseniasis (leprosy) from Brazil by 2005. The plan foresees the expansion of free diagnostic and treatment services integrated into the basic health services in at least 213 cities, access to rehabilitation procedures, and restructuring of the residential treatment facilities (so-called hospital colonies).

Workshop on Implementation Research (IR) in Leprosy (Rio de Janeiro, Brazil, 23–25 March 2004)
This workshop was co-organized by the Special Programme for Research and Training in Tropical Diseases (TDR) and the Oswaldo Cruz Foundation in Rio de Janeiro, Brazil. Twenty participants from ten countries and four TDR/WHO staff members took part in the event. Objectives were to develop a conceptual framework on challenges in leprosy elimination and integration; and for leprosy IR, to define research priorities, outline a priority plan, and develop a strategy for advocacy and fundraising. This page offers a summary of the meeting and access to the 11-page report and related links.
lep-rio-2004.htm lep-rio-2004.pdf

Report on the Sixth Meeting of the WHO Technical Advisory Group on the Elimination of Leprosy (Geneva, 9-10 February 2004)
Since 1985, the global prevalence has decreased by about 90% and more than 13 million patients have been cured with WHO-recommended multidrug therapy (MDT). The strategy has been applied with full political and professional commitment in all endemic countries (including Brazil), resulting in the attainment of the global target of less than one case per 10,000 population. The strategy also helped in focusing special attention on countries with a high disease burden. To date, out of 122 countries where leprosy was considered a public-health problem, only 10 countries still have to reach the elimination goal. This link takes the user to the full-text report on the WHO site

This page offers the user a panoramic view of all PAHO materials on leprosy. The documents are organized according to the following categories: surveillance, prevention and control, PAHO activities, Other PAHO Materials, and General Information/Links. It also contains a listing of featured items for all categories with the most important documents from each, and a side bar containing frequently requested items, upcoming events, and/or new books.

Leprosy Elimination Monitoring (LEM) in Brazil, 2003
The present publication is a contribution of PAHO-Brazil in conjunction with the Brazilian Ministry of Health, which aims to improve and promote access to nationwide information on leprosy (Hansen's disease). The reported data resulted from the LEM exercise undertaken in the 27 Brazilian states during June and August 2003 by technicians from two PAHO/WHO Collaborating Centers in Brazil: Lauro de Souza Lima Institute and Alfredo da Mata Foundation. This page offers access to an abstract, an executive summary, the full-text report (complete with tables and figures), the LEM guide, and other useful links on leprosy.

Reports from the Brazilian States for Leprosy Elimination Monitoring (LEM) 2003
This page offers access to the reports from the Brazilian states resulting from LEM 2003, an independent formal evaluation with standard indicators developed by WHO for collecting data to complement routine information systems and to allow for greater detail with regard to health services, quality of care offers, and access to multidrug therapy (MDT) at the local, state, and national levels. The page also lists the WHO standard indicators used in this exercise.

Frequently-Asked Questions about Leprosy Elimination
This booklet answers 69 questions on leprosy elimination and provides a glossary of common terminology. Questions are organized according to the following categories: strategic issues, global alliance, integration within general health services, communications strategy, special campaigns, technical issues, operational issues, role of WHO, and frequently-use terms.

CD44.R6: Primary Health Care in the Americas: Lessons Learned over 25 Years and Future Challenges
This resolution from the 44th PAHO Directing Council in 2003, taking into consideration the Declaration of Alma-Ata and past PAHO resolutions, sets forth the mandate of improving the quality of primary care in the Americas: more equitable access to health services, improved surveillance and information systems in this context, improved training for healthcare workers, a health promotion approach, better policy implementation, local community-based approaches and models, working towards the Millennium Development Goals, etc.

Brazil Leprosy Campaign Evaluation
PAHO/WHO commissioned the BBC World Service Trust to conduct a national radio and television leprosy awareness campaign in Brazil, in partnership with the Brazilian Ministry of Health, MORHAN, Pastoral da Crianca and Brazil’s major broadcasters. The month-long campaign consisted of three TV spots run 7,000 times and ten radio spots from 2,800 stations from 29 January–27 February 2003. This page gives the results and access to the ten-page executive summary.

WHO, List of Links on Communicable Diseases (by topic)
This list of links gives the user direct access to the main WHO pages on the various communicable diseases or on themes related to them.

Leprosy Elimination Monitoring (LEM): Guidelines for Monitors (2000)
Multi-Drug Therapy(MDT) is recognised as a major technological improvement in leprosy control. Assessment of interventions becomes particularly important when considering the leprosy elimination goal. The purpose of monitoring is to assist decision makers and programme managers to assess the progress towards leprosy elimination, to make a plan of action, to implement it and to measure its impact. Monitoring a minimum set of indicators that describes the MDT services will serve the purpose. This page provides access to the full-text WHO manual in downloadable PDF files. The Portuguese version of this manual was updated by PAHO-Brazil in 2003 for use in the Brazilian monitoring exercise.

Fact Sheet on Hanseniasis (Leprosy) in the Americas: Brazil's Pioneering Role in the Push for Elimination
This page offers basic information on leprosy (Hanseniasis) and the successful treatment brought about the multidrug therapy (MDT) recommended by WHO. It describes the key factors that have to be faced in the fight against this disease, and how Brazil has implemented a new strategy with positive results.

Photo Gallery: People Affected by Hanseniasis (Leprosy), Brazil
This collection of 30 downloadable photographs (in JPG) was sent by the PAHO Leprosy Elimination Team in Brazil. One of their main activities is to mobilize communities in detection, treatment, and elimination efforts to fight not only the disease but also the stigma and fear associated with leprosy. The focus is on people, projecting a more positive image than in the past.

Hansen's Disease in Brazil
Anchored in the 13th Technical Cooperation Agreement between CONASEMS, PAHO/WHO, and the Ministry of Health of Brazil, together with MORHAN and Child Pastoral Services, the objective of this collaboration agreement is to help the MS increase access to diagnosis and treatment through decentralization of basic care in its drive to eliminate the disease at municipal level.

No Role for Thalidomide in Leprosy
This paper from the WHO Leprosy team demonstrates that leprosy does not need thalidomide, which during the mid-1960s was reintroduced as treatment for a complication of leprosy called Erythema nodosum leprosum (ENL)--with the usual consequences. The paper outlines how other drugs work just as well, and without tragic side effects. The drug clofazimine is now a component of the multidrug therapy (MDT) introduced by WHO in 1981 as the standard treatment for leprosy, and which is now available from WHO free of cost to all patients in endemic countries, significantly reducing the frequency and severity of ENL reactions worldwide.

WHO Guidelines for Management of Severe Erythema Nodosum Leprosum (ENL) Reaction
The brief document makes available the WHO guidelines for managing leprosy using clofazimine and corticosteriods.

Fifth Meeting of the WHO Technical Advisory Group (TAG) on Elimination of Leprosy (Yangon, Myanmar, 9–10 February 2003)
Although much progress has been made towards the elimination of leprosy as a public-health problem, major challenges remain in several highly endemic countries. This set of 14 points provides an update of the state of the art in the drive to eliminate the disease.

The Yangon Declaration
This document offers the declaration made by the participants of the Third Meeting of the Global Alliance for the Elimination of Leprosy (GAEL), convened at the initiative of the World Health Organization (WHO) in Yangon, Union of Myanmar, from 6-8 February 2003 under the auspices of the Minister of Health, Union of Myanmar. The page links to the recommendations of the Technical Advisory Group and the WHO Leprosy Page.

WHO Disease Outbreak News
This link provides access to the latest WHO updates and archives on disease outbreaks throughout the world.

Leprosy in Brazil: Epidemiology and Social Aspects
This presentation of 40 PowerPoint slides focuses on the epidemiological and social aspects of leprosy in Brazil, complete with maps, geographical information and a photo gallery of the patients themselves, addressing the problems they face in the community (with a call for community involvement in local detection and treatment programs and strong popular campaigns to combat the negative image and stigma associated with this disease).

Pan American Journal of Public Health - Vol. 9, No. 2, February 2001
Revista Panamericana de Salud Pública/Pan American Journal of Public Health, Vol. 9, No. 2, February 2001

Guide to Eliminate Leprosy as a Public-Health Problem
This WHO booklet, part of a global initiative to eliminate leprosy, focuses on how multidrug therapy (MDT) cures that disease, interrupting its transmission and preventing disabilities. The booklet offers basic information on diagnostics, treatment and community-level prevention, available in a PDF file that can be downloaded, printed and distributed in all health and family-care centers.

WHA51.15: Elimination of Leprosy as a Public Health Problem
This resolution of the 51st World Health Assembly in 1998 sets forth the WHO global mandate for eliminating leprosy, which was adopted by PAHO for the Americas.

CD35.14: Eradication/Elimination of Certain Diseases from the Region
This resolution from the PAHO Directing Council sets forth the mandate for the eradication and elimination on onchocerciais (river blindness), Chagas Disease (American trypanosomiasis) through blood transfusion, and leprosy (Hansen's disease) from the Americas.

WHA44.9: Adoption of Multidrug Therapy for Elimination of Leprosy as a Public Health Problem
This 1991 resolution from the 44th World Health Assembly forms the basis for activities aimed at eliminating leprosy as a public health problem at the global level. It constitutes WHO's commitment to eliminating the disease as well as PAHO's mandate for the Americas.

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