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Leprosy and inequities in India's healthcare: beyond the persistent rhetoric of 'elimination'.

Abstract

Even as India achieved statistical elimination of leprosy at the national level in 2005, the target continues to be part of the country’s policy documents. But what is “elimination”, to begin with? The policy documents are unclear of its operational definition, of whether it is at the national level, the state level or the district level. Despite lack of clarity, the political leadership has not failed to indulge in the rhetoric of “leprosy elimination”. In 2018, India was supposed to have achieved national level elimination—yet again. This paper argues that these declarations are devoid of any positive public health significance, and the country is a long way from eliminating leprosy at the state or district levels. As witnessed in 2005, the declaration only served to make officials complacent, shifting resources away from the programme itself. Meanwhile, the data show worrying new trends: Leprosy is becoming highly concentrated amongst the Adivasis (Scheduled Tribes); and the number and proportion of states and districts with elimination-level prevalence is fast decreasing. The paper makes a case for Ayushman Bharat to be the opportunity for streamlining case detection and treatment.

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Type
Report