a disease that is far from eradicated but is still neglected

published on Saturday, January 28, 2023 at 07:42

Despite existing treatments, thousands of people continue to become infected with leprosy each year. Faced with this disease, which mainly affects poor countries, research continues, but only a few laboratories allocate funds for it.

Mathias Duck, a 44-year-old minister from Paraguay, was already familiar with leprosy because he had worked in a hospital for the sick. However, when he was diagnosed himself in 2010, it “it took him three years to be able to speak freely about it,” he told AFP.

A pathology often considered shameful, leprosy has the sad privilege of being one of the 20 tropical diseases considered neglected by the World Health Organization (WHO). This communicable disease, caused by the bacillus Mycobacterium leprae, affects the skin and peripheral nerves with potentially very serious consequences.

In 2022, according to the WHO, just over 216,000 cases of leprosy were recorded worldwide, particularly in Brazil and India. In 14 countries in Africa, Asia and Latin America, leprosy even remains “a big problem”.

Numbers that could only be the tip of the iceberg, according to doctor Bertrand Cauchoix, a specialist in the disease at the Raoul Follereau Foundation in France: “We know the number of patients examined, but we do not count the forgotten, undiscovered patients.” , which could be many more, he explains.

Because leprosy, favored by promiscuity and precarious living conditions, has a special feature: a very long incubation period, from a few years to 20 years. There is also a diagnostic delay, during which the patient can continue to infect relatives.

Medical treatment based on three antibiotics has been around for decades. Six months of treatment were enough for Mathias Duck: “I was very lucky because I was diagnosed and treated in good time, without any ailments.”

However, treatment can take longer, up to 12 months, making it difficult to carry out in countries without a health system.

“We need an infrastructure with nurses to administer the drugs, which requires resources,” recalls Alexandra Aubry, professor of biology and specialist in leprosy at the Center for Immunology and Infectious Diseases (Cimi) in Paris.

– ‘No money for leprosy’ –

In addition, the existing antibiotics are donated via the WHO by the foundation of the Swiss laboratory Novartis – which produces them. Bertrand Cauchoix therefore points to “a risk of very great tension” in the event of problems in the production line of these antibiotics.

In general, pharmaceutical laboratories do not strive to create new molecules that would be easier to administer. “There is no money for leprosy, only charitable donations,” laments Dr. cauchois

In fact, in Western countries, the disease is virtually non-existent and confined to a limited number of patients, in countries where new drugs are unlikely to come at a high cost.

In her research laboratory in Paris – one of the few in the world that can carry out tests on this bacterium that cannot survive in Petri dishes – Alexandra Aubry evaluates the effectiveness of each new antibiotic that comes to the market to treat other diseases.

“We are trying to identify associations of antibiotics,” she explains. “We try all possible simplifications to do shorter treatments, for example once a month for six months.”

There are also vaccination projects, all the more rare because there too there is a lack of funds for a disease whose onset is delayed.

‘Financing this is very complex. To assess the effectiveness of a vaccine you have to follow the vaccinated population for 10 to 15 years,’ recalls Professor Aubry.

“If we compare to what happened with Covid, it’s really just a drop in the bucket,” adds Mathias Duck, who is calling for both more research and more political will around the world to eradicate the disease.


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