Dr. Quao, a “realistic optimist” at the forefront of the fight against leprosy in Ghana
"Achieving the objectives of the Towards Zero Leprosy Strategy by 2030 in Ghana seems a realistic goal if current efforts continue."
Introduction:
The Towards Zero Leprosy Strategy, instigated by the WHO, aims to eliminate leprosy as a public health problem by 2030. This ambitious plan focuses on reducing the incidence of new cases, eliminating leprosy-related disability and eradicating the stigma associated with the disease. In Ghana, the national leprosy programme has been actively working towards these goals, with the support of the Anesvad Foundation.
Anesvad Foundation:
Benedict, how has the number of leprosy cases in Ghana changed in recent years?
Benedict Quao:
Since the implementation of the Anesvad Foundation project in 2018, we have seen some positive changes. Although initially there was a slight decrease in cases, the numbers fluctuated between 250 and 280 cases for a few years.
We believe this was due to improved case detection: it’s not that there were more cases, it’s that we were detecting them better. In 2022, we started introducing chemoprophylaxis in the most endemic regions, and we are now seeing a possible decrease again, with around 230 cases reported last year.
Anesvad Foundation:
What strategies are you implementing to reduce the number of cases, especially among children?
Benedict Quao:
We are focusing on contact management and chemoprophylaxis to reduce cases among children. Our goal is to reach zero child cases at least one year earlier than 2030. The introduction of these measures is helping to bring down the overall numbers and we expect to see a continued reduction.
Anesvad Foundation:
What is the situation regarding disability associated with leprosy?
Benedict Quao:
Although the numbers of cases are decreasing, the proportion of cases with disability remains high.
In 2022, 13% of our cases presented with disability. We are following up more closely and referring these patients for appropriate treatment. Despite the challenges, detecting and monitoring these cases allows us to address the problem more effectively.
Anesvad Foundation:
What is being done to address the stigma and marginalisation associated with leprosy?
Benedict Quao:
We have implemented a psychosocial support project with the help of the Anesvad Foundation, which has trained our staff in how to deal with potentially stigmatising conditions.
Mental health and disease management teams are now better equipped to deal with these problems. In addition, we have revised our treatment record cards to include specific mental health issues and referrals where necessary.
Anesvad Foundation:
How does patient empowerment contribute to the fight against leprosy?
Benedict Quao:
Patient empowerment is crucial. Don’t forget that it’s often the patient who stigmatises themselves the most: they become convinced that they can’t continue their community and social life after getting the disease.
When patients have a better understanding of the disease and the options available to them, they can participate more actively in the community and tackle this self-stigma. Our counselling teams work with patients to attain this self-awareness and increase their participation in community events.
Anesvad Foundation:
What support have you received from external organisations, and how is it influencing your work?
Benedict Quao:
We are deeply grateful for the support of the Anesvad Foundation and other partners. Their commitment as regards leprosy and other neglected tropical diseases is critical, since the patients are often people who have no voice.
The support of the Anesvad Foundation has been crucial in enhancing our focus on the well-being of affected people and motivating us to continue working hard to eradicate leprosy and other neglected diseases.
Anesvad Foundation:
With all this in mind… Do you think Ghana will be able to eliminate leprosy by 2030?
Benedict Quao:
I’m realistic about the challenges we face, but also optimistic. The implementation of strategies such as chemoprophylaxis and psychosocial support is having a positive impact.
If we continue these efforts and keep the focus on the critical areas, I believe we can come very close to the goals of the Towards Zero Leprosy Strategy by 2030. However, it will be essential that we continue to monitor the data and adapt our strategies as needed.