Through the ages, people all over the world were condemned to live under cruel and inhumane conditions because of the disease. Even after effective treatment was developed in the mid-twentieth century, those affected by leprosy continued to be subjected to discrimination.
Leprosy is one of the oldest diseases known to humankind
Historical evidence suggests that it originated in East or West Asia, but recent genomic analysis has traced the disease to East Africa some 10 million years ago. Other theories claim that leprosy spread globally as early humans dispersed from Africa.
Leprosy spreads with invasion and expansion of empire
Leprosy is thought to have spread along the Mediterranean coast with the campaigns of Alexander the Great and further into Europe with the expansion of the Roman Empire. Later migrations of Germanic tribes in the fourth century, the expansion of Islam from the eighth century, and the Crusades are considered to have contributed to further dissemination in Europe.
Misunderstanding traced back to Bible
The image of leprosy and the entrenched misunderstanding of it can be ascribed to accounts in the Bible, or more precisely, to translations of the original text. In the Bible, “lepra” is synonymous with “impurity of sin.” Current scholarship indicates that both the terms “lepra” and “leper” were used as direct translations of the Hebrew term “zaraath,” a general term that referred to other skin afflictions, but not necessarily to leprosy.
Expansion of endemic areas in Europe, systemized discrimination, and aid efforts
From the seventh to the fifteenth centuries, as leprosy became more prevalent in Europe, discrimination against those affected by the disease also grew, leading to their banishment from the community. Many facilities for the care of those affected came to function as places of quarantine and isolation from society. On the other hand, Saint Francis of Assisi devoted himself to the relief of those affected by leprosy by establishing “leprosy villages” where the residents’ freedom was respected. This was the start of efforts to aid those affected by leprosy by Elizabeth, a princess of the kingdom of Hungary, later canonized Saint Elizabeth of Hungary, and others in the thirteenth century.
The Retreat of Leprosy in Europe
Starting in the 15th century, the number of persons affected by leprosy began to decline in Western Europe. Thereafter, although leprosy became prevalent at times, it had nearly disappeared by the 20th century. However, during the Age of Exploration, leprosy spread from Europe to other lands, and the number of those affected increased in Canada and the United States.
Start of Medical Treatment for Leprosy and Relief Work in Modern Times
In 1873, Gerhard Armauer Hansen identifies Mycobacterium leprae as the bacterium that causes leprosy, marking the start of medical diagnosis and treatment of leprosy.In 1874, Wellesley Bailey, a Christian missionary, establishes The Mission to Lepers (now known as The Leprosy Mission or TLM), which provides care for people affected by leprosy including hospice care for elderly patients in many countries today, primarily in India and former British colonies.
The First Effective Treatment
In 1941 the drug promin is administered for the first time at the National Leprosarium in Carville, Louisiana in the United States. Thanks to promin, leprosy becomes curable, but the drug can only be administered by injection and causes a number of side-effects.
Initial Support (1967─1981)
Established in 1962, The Nippon Foundation (formerly, the Japan Shipbuilding Industry Foundation) started its activities to fight against leprosy with providing assistance for building leprosy-related facilities around the world and financial assistance to WHO for leprosy-related programs.
- The Nippon Foundation (formerly, the Japan Shipbuilding Industry Foundation) helps fund a leprosy hospital in Agra, Uttar Pradesh in India.
- Dapsone, the new drug introduced after promin, has a relapse rate of approximately 30%.WHO establishes THELEP to develop a new regimen and IMMLEP to research a vaccine.
- Sasakawa Health Foundation (SHF: formerly, Sasakawa Memorial Health Foundation, SMHF) was established in 1974 with the goal of eradicating leprosy. Its co-founders were Mr. Ryoichi Sasakawa, founder and first chairman of The Nippon Foundation and Prof. Morizo Ishidate, father of chemotherapy for leprosy in Japan.
- The Nippon Foundation begins funding WHO programs to eliminate leprosy. This support enables WHO to expand its leprosy section and strengthen its programs and activities. with around US $ 2-4 million fund provided annually by The Nippon Foundation, reaching approximately US$ 143 million by 2017.
- SHF begins support for joint international research on chemotherapy for leprosy continuing this support until 1988.
- SHF publishes “The Atlas of Leprosy: A Pictorial Manual to Assist Frontline Health Workers and Volunteers in the Detection, Diagnosis and Treatment of Clinical Leprosy.”
- At the THELEP Conference in Geneva, a multidrug therapy, a regimen of three drugs consisting of dapsone, rifampicin and clofazimine, is recommended by a WHO study group as treatment for leprosy.
Eliminating Leprosy and Post-Elimination (1991─)
Thanks to the development of MDT, leprosy became a completely curable disease. As a result of the free provision of MDT since 1991, the effort to eliminate leprosy shows dramatic results.
- The 44th World Health Assembly adopts a resolution to achieve the global elimination of leprosy as a public health problem by the year 2000, defining elimination as a level of prevalence below one case per 10 000 population.
- The First International Conference on the Elimination of Leprosy as a Public Health Problem is held in Hanoi, Vietnam. The Nippon Foundation pledges to distribute MDT free of charge for a five-year period from 1995.
- The Global Alliance for the Elimination of Leprosy (GAEL) is formed.
- The Elimination of leprosy at the global level is achieved by year’s end.
- Yohei Sasakawa is appointed WHO Special Ambassador to the Global Alliance for Elimination of Leprosy.
- After the last meeting of the Global Alliance in 2003, Yohei Sasakawa is appointed WHO Goodwill Ambassador for Leprosy Elimination.
- India achieves the elimination target at the national level. This is an encouraging achievement for other countries.By 2011, Mozambique, the Democratic Republic of Congo, Nepal, and East Timor also achieve elimination, leaving Brazil as the only country with a population of over 1 million yet to do so,
- To discuss strategies to overcome the remaining challenges, The Nippon Foundation and WHO jointly organize “The International Leprosy Summit” in Bangkok, Thailand. During the summit, the Bangkok Declaration is adopted by the representatives of 17 nations. The Nippon Foundation announces the launch of US$ 20 million of Bangkok Declaration Special Fund.
International Leprosy Summit: Overcoming the remaining
challenges, Bangkok, Thailand, 24-26 July 2013.
- The Global Partnership for Zero Leprosy (GPZL) is established and Sasakawa Health Foundation becomes its member.
- The Office of Joint Program on Hansen's Disease was established in April 2018 to integrate leprosy programs of The Nippon Foundation and its affiliate, Sasakawa Health Foundation.
- Having reflected the “Guidelines for the Diagnosis, Treatment and Prevention of Leprosy” published by WHO in 2018, SHF revises “New Atlas of Leprosy: A pictorial manual to assist frontline health workers and volunteers in the detection, diagnosis and treatment of leprosy.
Leprosy as a Human Right Issue (2003─)
Yohei Sasakawa and The Nippon Foundation focus on the discrimination and stigma associated with leprosy and begin efforts to address this as a human rights issue at the global level.
- Yohei Sasakawa visits the Office of the UN High Commissioner for Human Rights in Geneva to request that the United Nations take specific measures to resolve discrimination related to leprosy.
- Yohei Sasakawa addresses leprosy as a human rights Issue at the regular session of the United Nations Commission on Human Rights. Five months later, the UN Sub-Commission on the Promotion and Protection of Human Rights resolves to conduct leprosy study from human rights perspective.
- The above UN Sub-Commission adopts resolution that calls for ending discrimination against persons affected by leprosy. For the first time, a person affected by leprosy addresses the United Nations Commission on Human Rights.
- The Nippon Foundation launches an annual Global Appeal to End Stigma and Discrimination against Persons Affected by Leprosy.> Global Appeal
- Sasakawa appeals strongly against a ban based on an existing law by the organizing committee of the Beijing Olympic Games on persons affected by leprosy who wish to enter China, and the ban is subsequently lifted.
- The United Nations Human Rights Council adopts a resolution on elimination of discrimination against persons affected by leprosy and their family members.
- At the United Nations General Assembly in New York, a resolution on elimination of discrimination against personsaffected by leprosy and their family members, along with accompanying principles and guidelines is adopted unanimously by the 192 member countries.> principles and guidelines
- Yohei Sasakawa, Chairman of the Nippon Foundation, expresses concern over remarks by Pope Francis that refer to “lepers” as a negative metaphor.
His Holiness the Dalai Lama and Sasakawa at a town hall
meeting in a leprosy colony, India, 2014.
- The Nippon Foundation, S-ILF and His Holiness The Dalai Lama, who shares the objectives of S-ILF, offer starts the “His Holiness The Dalai Lama - Sasakawa Education Scholarship” for youth from leprosy colonies in India.
- UN Human Rights Council adopts resolution that calls for advisory committee to review implementation of principles and guidelines for elimination discrimination against persons affected by leprosy and their family members.
- The Nippon Foundation and the Pontifical Council for the Pastoral Care of Health Care Workers bringing co-sponsor the Vatican’s first international symposium on leprosy, Towards Holistic Care for People with Hansen’s Disease, Respectful of their Dignity.
Sisters focus on the discussion at the symposium,
- UN Human Rights Council adopts resolution that calls for three-year appointment of Special Rapporteur on elimination of discrimination against persons affected by leprosy and their family members and The Nippon Foundation expresses its expectation.