- Volume 70 , Number 4
- Page: 307–12
Welcome greetings
MESSAGE F ROM THE HEALTH MINISTER
Dear Participants
First of all, I would like to express the pleasure of the Ministry of Health for the accomplishment of the International Leprosy Congress in Brazil. This is an important landmark in the fight against this disease. Since the last Congress in Brazil, in 1963, great progress has been achieved, including the simplification of diagnosis techniques and the introduction of MDT that represents today, after 40 years, a real possibility for the elimination of leprosy as a public health problem by the year 2005.
In addition, 1 mention the important initiative of creating the Global Alliance that has as its main target the mobilization of the 12 countries that still have leprosy as an endemic disease for the "Final Push" towards elimination of this disease, uniting all these partners for that goal. Presently, Brazil is the leading country of the Alliance.
At this occasion, I confirm again that Brazil is firmly pledged to reaching that goal. The probabilities of that are highly favorable, considering the results obtained so far and the actions that have been undertaken. During the last 15 years, the occurrence of leprosy was reduced by more than 80%, and more than 80% of the diagnosed cases are concentrated in 329 municipalities in Brazil, which represent 5.93% of the total amount in the world.
The efforts towards elimination of leprosy are concentrated in the effective insertion of prevention, diagnosis and treatment in the basic health services, which process is fast advancing in the country through reorganization and strengthening. It is at this level of attention that we identify the ideal conditions for the elimination of leprosy, keeping in mind the extensive coverage, the integration to the respective community and the high degree of resolution, especially related to this disease.
This process, which has been undertaken in Brazil, comprises essential strategies such as the Family Health Program and the Community Agents (PSF and PACS). There are more than 50 million Brazilians being followed-up by the health groups of PSF, that are visited by more than 160 thousand Health Community Agents, trained to orient the families and to detect signs of the disease, as well as to refer suspicious cases to the basic health units.
As part of the attempt to reach the elimination goal, the Ministry of Health began in November 2001, together with the states and municipalities, the National Plan for the Mobilization and Intensification of the Actions for the Elimination of Leprosy. This Plan aims to reach the most diverse segments of society, so that resources can be added and strengthened.
Taking into consideration this positive context, Brazil is hosting the 16th International Leprosy Congress, wishing to all participants, from Brazil and abroad, a successful event, convinced that the final conclusions will be an important push towards the elimination of this disease in Brazil and in the world.
- Barjas Negri
Minister of Health
MESSAGE F ROM THE WORLDHEALTH ORGANIZATION
The 16th International Leprosy Congress will convene at a crucial moment of high optimism in the elimination of leprosy balanced with the remaining challenges faced by endemic countries. Tremendous progress has been made in improving access to the treatment of leprosy.
The World Health Organization continues to coordinate efforts to ensure that leprosy will be eliminated as a major public health problem. At the same time, changing and frequently uncertain political, economic and social climates in many leprosy endemic areas place heavy new burdens upon government health-care networks: funds are limited, and there are many other major health concerns. In addition, changing the negative image of leprosy and making sure that no individuals will suffer from discrimination due to present or past leprosy still poses formidable challenges. Discussion and recommendations of the participants at the Congress will be very valuable in the consideration of these matters.
The WHO is grateful to the Government of Brazil and members and the Organizing Committee for planning the Congress. WHO is honored to cosponsor this important event together with the Ministry of Health of Brazil, ILA and ILEP. The 16th International Leprosy Congress will benefit all who are concerned with leprosy and leprosy patients throughout the world. WHO looks forward to the exciting opportunities the Congress will provide for the exchange of information on advances in the study of leprosy, and for the continuing education of all who work toward the eradication of the disease and its consequences.
- Dr. Maria P. Neira
Director CPE/PCD
MESSAGE F ROM THE ILA PRESIDENT
Dear Colleagues and Friends,
This XVIth International Leprosy Congress, organized by the International Leprosy Association, jointly sponsored by WHO and ILEP, and kindly hosted by the Federal, State and Municipal Governments of Brazil, Bahia and Salvador, stands at the start of the 21st Century, during which we should surely see the end of our millennia long struggle against the disease, by achieving "A World without Leprosy." At this congress, ILA, trying to assume a more proactive role, intends to present to its participants, and to the world at large, the ways and means to reach that goal, lor their consideration and hopefully eventual adoption, by those who are actually responsible in implementing various measures of leprosy control in the field, as well as of care to individuals who need support due to residual physical and social difficulties.
To fulfill the above-mentioned task. ILA has organized an ILA Technical Forum in February this year. First we have appointed five members of ILA, each well-known for his expertise in various aspects of leprosy work, vis Epidemiology, Diagnosis and Classifications, Treatment, Impairment and Rehabilitation, and Sustainable Leprosy Services, and they have jointly identified 15 key questions which, in their considered opinions, must be answered adequately in our effort to reach "A World without Leprosy." Since our intention is to come up with as many evidence-based recommendations as possible to these 15 key questions, a mechanism was set up both in Amsterdam, to identify and collect as many abstracts of published articles related to these questions as possible, and in Aberdeen, to go over those abstracts and then choose and obtain relevant full papers. By December last year, more than 7000 abstracts were examined, and more than 800 full papers were obtained and distributed among those five core members. They have come up with a draft paper including draft recommendations to questions to which they are assigned.
At the Forum itself, about 15 more experts were invited, some belonging to MOH of endemic countries, others to WHO and several other organizations, but all as individual experts and not as representatives of any agencies or organizations. They have had intensive discussions over four working days based on the draft paper, which was given to them well in advance to the forum. The main points of the discussion will be published, together with the recommendations, as that of the ILA Technical Forum, which I trust will have enough objective scientific authority based on the participants' expertise, without institutional or political biases.
During the congress, the outcomes of the forum will be presented, under five headings, followed by discussion by a panel, consisting of two or three members of the forum plus two or three to four non-forum members, then a question and answer session involving congress participants in general. Since all the participants of the congress will receive the published report of the forum at registration, anyone interested could make enough preparations to ask relevant questions at the Q/A sessions.
From the above, 1 trust that you will agree with me saying that the XVIth Congress is likely to be one of the best planned and prepared congresses in its history, which stretches back to its first meeting in Berlin in 1897, more than 100 years ago.
Thanks to our hardworking Brazilian colleagues in the organizing committee, under its able and patient chairperson. Dr. Marcos Virmond, and Dr. Euzenir Nunes Sarno, in charge of the scientific program, there will be a rich program of traditional paper presentations, either oral or poster, precongress workshops, state of the art lectures, seminars, conferences, training sessions, etc., which should meet the needs of most of the congress participants.
So welcome to the XVIth ILC in Salvador, Brazil. Let us meet and equip ourselves in our effort to achieve "A World without Leprosy" as soon as possible, so that when that goal is achieved, people would say that this congress was indeed the start of the "Final Push."
- Yo Yuasa
President
MESSAGE F ROM THE PRESIDENT OF THE ORGANIZING COMMITTEE
The first International Leprosy Congress took place at the end of the 19th century. Our Congress, the 16th, is being held at the beginning of the 21 st century.
There are significant parallels. We begin the new millennia with the responsibility of eliminating leprosy counting on the scientific knowledge produced by our colleagues since that long ago date.
Indeed, our responsibility increases as we recognize that our present knowledge differs little, in general terms, from what was discussed in the Berlin Congress in 1897.
Perhaps, the major achievement in this period has been the advent of an effective treatment and the influence of that on the concept of cure and the demystification of leprosy as a plague, chastisement or curse.
We recognize that, despite the dramatic reduction in prevalence, the efforts in the scientific field must continue and should be strengthened. In this sense, we hope that the 16th International Leprosy Congress will be a privileged forum in which to celebrate the significant achievements obtained so far.
However, it should be also the occasion for deep reflection on the future challenges and the continued need to search for responses to the many unanswered questions regarding this intriguing disease.
As a multidisciplinary scientific forum, we hope also that the 16th ILC will be a quiet harbor in which all interests and viewpoints come together with their knowledge and personal commitment as weapons in the common task of protecting our fellow citizens from leprosy.
- Marcos da Cunha Lopes Virmond
President of the Organizing Committee
MESSAGE F ROM THE ILEP PRESIDENT "WORKING TOGETHER FOR A WORLD WITHOUT LEPROSY"
The last twenty years have seen great progress in the treatment of leprosy. These days treatment for leprosy with multi-drug therapy is straightforward and can usually be completed within a year of diagnosis. Early diagnosis and treatment means that people affected by leprosy suffer less nerve damage and disability than in the past- treatment allows people to lead a normal life.
All this means that gradually the perception of leprosy is changing and the stigma attached to the disease is slowly diminishing. People increasingly understand that leprosy is a bacterial infection, which is easily treated and not very contagious.
Does this mean we will soon be able to forget about leprosy? In fact, we are at a critical time in the history of leprosy. Shorter, more effective treatment has meant that the number of people registered for leprosy treatment has fallen dramatically. However, the number of people found to have leprosy each year has not yet fallen in the same way. In addition, many people who have had leprosy, including a proportion of the people receiving treatment now and in the future, will suffer nerve damage and possible disability. In some cases these people may still experience serious social or economic disadvantage.
We are at a point where decisions about the future of leprosy services need to be made with intelligence and care. We need to build on achievements so that in the future, people with leprosy will be able to rely on good quality services for treatment, prevention of disability and rehabilitation. We need to do this by careful analysis of needs, thoughtful and strategic planning and effective monitoring of programs. We need to make accurate diagnoses before treatment. We need to support the capacity of governments to provide leprosy care through general health services to achieve increased effective coverage of the population, and to make the services more sustainable. We also need to maintain specialist expertise in leprosy. Above all. we need to remain responsive to changing needs.
ILEP Members know that leprosy is not a high-profile disease, but we know too the devastating consequences people can experience where care is inadequate.
By working together with governments and other agencies, ILEP commitment to work for a world without leprosy, will help ensure the provision of sustainable, quality services for the treatment and care of people affected by leprosy for as long as they are needed.
- Terry Vasey
President