When people think of leprosy, they may think of an extinct disease; a Biblical sickness that has long lived in the past. This could not be further from the truth, as leprosy or Hansen’s disease affects millions of poverty-stricken individuals throughout the world. One of the largest concentrations of leprosy in the world is in Brazil, which combined with India and Indonesia, accounts for 81 percent of all leprosy cases worldwide. Here is some information about Brazil‘s fight against leprosy.
What is Leprosy?
While leprosy is a debilitating disease that has existed for centuries, there is a myriad of misconceptions about how it spreads and functions due to its ancient status. Leprosy is an infectious disease that the pathogen, Mycobacterium leprae, causes. It affects the skin, eyes, peripheral nerves and upper respiratory tract of its victims. Common symptoms are skin lesions, often accompanied by sensory deprivation and weakness of muscles near the afflicted area.
People currently do not know how leprosy spreads, but physical contact with an infected person or creature was the predominant theory for a long time. Recently, the theory that leprosy spreads through respiratory routes (i.e. coughing and sneezing) has been gaining traction. Leprosy infection can happen regardless of age, but 20 percent of registered cases occur before a child turns 10. While leprosy is just as likely to infect boys as girls, adult rates for leprosy show a different story. In fact, leprosy is twice as prevalent among adult males than it is among females.
If a person with leprosy does not receive treatment, it will often lead to blindness, loss of extremities (i.e. fingers and toes) and arthritis. Leprosy has crippled 1 to 2 million people across the globe. There is hope, however, as leprosy is curable with antibiotics and if a person receives treatment early enough, they can expect a full recovery with little to no complications.
Poverty and Leprosy
Poverty and leprosy go hand in hand. Wherever there is leprosy, poverty is sure to follow. There are a plethora of reasons why poverty and leprosy often co-exist, and one of the main reasons is that those with leprosy and unable to receive a cure will very often find themselves unable to work due to the crippling disabilities of the disease. Once the serious disabilities from leprosy settle in, sufferers are hard-pressed to survive, let alone work to make enough money to afford proper treatment. This subsequently traps them in a brutal cycle of poverty, unemployment and social pariah status.
However, there are many NGOs working to eradicate leprosy by taking on poverty as well. One such NGO is the No Leprosy Remains group (NLR), which has been working towards the complete elimination of Hansen’s disease in Brazil since 1994. As of 2017, NLR’s main mission is to achieve a 90 percent decrease in the number of people needing treatment for neglected tropical diseases (leprosy being one of them). To reach this goal, NLR has enacted the PEP++ plan to preemptively treat over 600,000 people and reach a 50 percent reduction in new leprosy cases compared to its starting year.
Brazil’s fight against leprosy has been a tumultuous one; with Brazil contributing to 93 percent of all leprosy cases in the Americas in 2018. One can attribute Brazil’s status as a hotspot for leprosy to the fact that it is a very large country with many remote areas in hard to reach places, leading to difficulties in diagnosing people with leprosy, let alone curing it.
However, there is one cause of leprosy that is entirely unique to Brazil, the armadillo. In Brazil, testing determined that 62 percent of nine-banded armadillos were hosts to Mycobacterium leprae. Furthermore, Brazilians who ingested nine-banded armadillo meat on a regular basis had higher concentrations of leprosy antibodies in their bloodstream. This is problematic given that armadillo meat is a common source of protein for Brazilians in lower socioeconomic areas where food is not as plentiful. To counteract this, NLR’s PEP++ program has a focus on community education that aims to teach about the social impact of leprosy as well as techniques and knowledge that are vital to curbing this disease.
The Future of Brazil’s Fight Against Leprosy
Brazil is making headway in its fight against leprosy. The Brazilian government has been tackling the threat of leprosy with renewed vigor since 2003 and has shown remarkable improvement in the treatment and diagnosis of this disease. The Brazilian government, with the help of NLR and the World Health Organization, should meet PEP++’s 2030 end goal of a 90 percent reduction in leprosy cases annually.
– Ryan Holman