Leprosy has a 4,000-year history. A skeleton from 2,000 BC was discovered with signs of leprosy in India, where today, more than 100,000 of the 200,000 new cases each year are recorded. The disease has followed humanity since near the beginning of recorded history. It is fitting, then, that what represents our future in technology may offer the means to end our oldest affliction. AI identification tools can identify signs of leprosy quickly and easily, a previously missing step in eradicating it. 

Over the 20th century, people eradicated leprosy by 99%. It is easily treatable today with inexpensive drugs and has a low transmission rate, taking months of close contact to spread. Even so, the disease has survived. In history, cases of leprosy have likewise waxed and waned, though they have never completely disappeared. Its survival today reflects how it survived in the past with a mixture of disinterest and stigma. 

About Leprosy and Poverty

“Leper” is often a general derogatory term for an outcast. Although many associate this term with Medieval times, misunderstanding and discrimination still follow leprosy. Until 2019, leprosy was legitimate grounds for divorce in India. From the early 1900s, Japanese people suffering from leprosy were forced to live in sanitariums, with many still there to this day. These laws reflect those made in the past, driven by a false fear of infectiousness and prejudice toward its physical effects. The disease has been hard to eradicate as people are ashamed or afraid to admit they might have it, with good reason. The progress in fighting the disease has, too, had the unintended side effect of creating in leprosy-free societies a lack of interest in the disease or, at times, awareness it still exists at all. 

Leprosy worsens poverty, and poverty worsens leprosy. Although the disease is easily treatable, poorer and isolated communities lack the expertise to identify it and access to medicine to treat it. Even in cases where the disease has been cured, physical disabilities due to leprosy remain, and then so does stigma. People suffering from leprosy have a more challenging time finding employment. In a study made in southern Ghana, 25 of 26 patients with leprosy were unemployed. One of them said, “Some public transport drivers refuse to pick us up when they discover our deformity. If we go out to shop, some people snub us.” Patients internalize this stigma, and some do not think it is worth trying to find work. This reflects deterioration in mental health. 

Leprosy in Nepal

In a study taken in southern Nepal, thoughts of suicide and self-harm were 30% higher in those suffering from leprosy. A 2018 study in rural Indonesia concluded that lower income and food insecurity increased the disease risk in endemic areas, while education and land ownership reduced it. All of this is to say leprosy creates poverty, and poverty creates conditions that allow leprosy to survive.

There is an obvious benefit to effective and simple diagnosis of the disease. It makes expertise less necessary, and early diagnosis lessens the chance of lasting disability. With this fact in mind, researchers working with Microsoft are creating AI leprosy diagnosis tools for smartphones.

Microsoft’s Work

In 2020, Microsoft announced it would invest in medical AI, one of the fields being the treatment of leprosy. With this funding, the Novartis Foundation, a nonprofit finding solutions to global illness, has created AI4Leprosy, a leprosy diagnosis tool that “has the potential to accelerate leprosy diagnosis significantly.” By training an AI on thousands of images of symptoms, Novartis aims to create a tool that can recognize signs of the disease using a phone camera. Results have been promising. Novartis published a report in 2022, where they found their AI was 90% effective in recognizing symptoms. 

In 2021, the World Health Organization (WHO) unveiled its strategy for eliminating leprosy by 2030. It recognized early diagnosis as necessary. Without it, even cured cases may carry lasting disability and the stigma and poverty that has come with the disease since ancient times. Even if leprosy is not as prevalent as it once was, removing it makes for a potent symbol in the fight against disease and the ancient prejudices that come with it.

– Frederick Lake
Photo: Flickr