Revitalizing Leprosy Control in Nigeria: A Call to Action

Leprosy, often dubbed a "neglected disease," casts a long shadow in Nigeria. It's more than a medical concern; it's a societal challenge demanding an unwavering commitment to eradication. As the Head of Programs at The Leprosy Mission Nigeria aptly stated, leprosy is one of the most neglected among neglected tropical diseases, highlighting government neglect and a broader societal indifference.

Worldwide, half a million new cases of leprosy are discovered annually, and the total number of people afflicted is at least 10 million. Source: Wen-Yan King

Despite its ancient history, leprosy, or Hansen's disease, remains a powerful force, causing irreversible disabilities affecting the skin, peripheral nerves, and respiratory tract. Commendable past efforts, including establishing the National Tuberculosis and Leprosy Control program in 1989, brought leprosy to the brink of eradication by 2000. However, a lapse in focus allowed this devastating disease to regain momentum, classifying it as one of Nigeria's Neglected Tropical Diseases (NTDs) by the World Health Organization (WHO) today.

The statistics paint a sobering picture. Over 3,500 new leprosy cases are diagnosed annually, leaving a staggering 25% of patients grappling with various disabilities. Nigeria, with 17,356 new cases between 2010 and 2014, stands tall (or rather grim) as one of the world's leprosy-endemic nations. While progress has been made, reducing new cases from 5,981 in 2001 to 2,095 in 2018, the journey ahead necessitates a renewed commitment.

Beyond the cold statistics lie human stories etched in pain and resilience. Leprosy-related stigma and prejudice run rampant in Nigeria, fueled by deeply ingrained misconceptions and superstitions surrounding the disease. Discrimination, isolation, difficulties in finding partners and employment, and shattered social connections become a defining reality for people living with leprosy (PLWL), aptly described as a "social killer."

To truly understand their plight, I embarked on a crucial research mission, visiting seven leprosy settlements across diverse regions of Nigeria. The words of a PLWL from Zamfara State resonated deeply: "I have been living here for 30 years. It has not been easy; we face a lot of stigmatization, and there are no jobs."

These settlements, numbering 64 across 36 states, echo the same struggles: limited access to funding, healthcare, basic amenities, and overall support. The July 2022 protest in Delta State, where PLWL advocated for an increase in their monthly allowance, exemplifies the financial strain they endured.

While NGOs and missionary organizations like the Damien Foundation, the German Leprosy Relief Association, and The Leprosy Mission International have provided essential support, this reliance on non-governmental entities cannot be the long-term solution.

Shaping a sustainable future demands a stronger, more active stance from the government. Adequate and consistent funding ensures efficient water supply, shelter renovations, and prioritized sanitation and hygiene services within these settlements. The heartfelt plea of a PLWL in Niger State, "What happens when the missionaries leave, what will happen to us? The government isn’t doing anything," underscores the urgency of a more robust governmental approach.

Educational services, encompassing both formal and informal settings fostered by civil-based organizations and supported by the government, are crucial for empowering PLWL and creating an environment conducive to their reintegration into society. Additionally, nationwide awareness campaigns aimed at debunking myths surrounding leprosy are essential to dismantle the walls of stigma and prejudice.

Investing in research and evaluating existing efforts is equally crucial for developing a strategic plan addressing current gaps and vulnerabilities. Healthcare professionals must be equipped with the necessary knowledge and skills through comprehensive training programs. While the National Tuberculosis and Leprosy Control Program aims for program employees to undergo refresher training every three years, consistent adherence to this policy is critical to ensure a competent and well-equipped workforce.

Nigeria has made strides, with over 33,000 patients successfully treated since 2009. However, these numbers represent only a fraction of the unwritten success story. Donors and NGOs have played a vital role, but they cannot be the sole bearers of the responsibility. The government must step up and embrace a sustainable and comprehensive approach that prioritizes the well-being of PLWL.

Eradicating leprosy in Nigeria is possible, but it requires collective action and unwavering commitment. We must bridge the gap between rhetoric and tangible action, envisioning a future where leprosy is not a statistic but a chapter closed in the nation's history. Through united efforts, unwavering compassion, and unwavering dedication to the well-being of all its citizens, Nigeria can rewrite the narrative of leprosy, leaving behind a legacy of inclusivity and hope.