Who we are News Raising awareness to beat leprosy Guest blogger, Shalin Abraham from Polygeia writes about leprosy and the importance of raising awareness to help beat the disease. I’m in my penultimate year at medical school. When asked to write this blog, I cast my mind back to my years in lecture theatres, learning intricate details about the cells involved in the immune system or molecules involved in fat and sugar digestion, to diseases plaguing the western world, such as heart disease and diabetes. I can only recall one lecture where leprosy was mentioned briefly. Other neglected tropical diseases, such as schistosomiasis, were better slightly covered due to their weird and wonderful parasite life cycles. Certainly, the importance of neglected tropical diseases causing severe psychosocial and economic burden on ostracised communities and their entwinement with poverty, marginalisation and disempowerment, was not discussed. These factors are at the forefront of answers to the critical question… Why has leprosy been so difficult to eliminate? I can think of a few reasons for the lack of attention given to leprosy in medical education in the UK. Simply put, it is just not as relevant to the health burden in our own country. Limited funding in healthcare mean resources must focus on the diseases that cause high morbidity in our communities. Most people might think of leprosy as a ‘biblical’ disease, which affects relatively few people globally. Furthermore, unlike other tropical diseases such as malaria, leprosy receives little media coverage and attention or funding in research and development. Therefore, medical education neglects leprosy in favour of diseases of affluence, such as cancer or heart disease, and ‘high profile’ tropical diseases, like malaria, or ones causing humanitarian crises, such as Ebola. If health leaders, the media and the government in the UK neglect diseases like leprosy, then the wider population will also believe that it is no longer on the global agenda. Why is it important to raise awareness of leprosy, particularly among the medical profession? Firstly, leprosy is not completely irrelevant to medicine in this country. Mycobacterium leprae, the bacteria that causes leprosy, can have an incubation period of up to twenty years, making the spread much harder to predict. With increasing global travel and human migration, cases of leprosy could still be seen in the UK, just as TB has seen a recent resurgence in some pockets of the country. It is important for UK health professionals to be able to recognise the symptoms and treat the patient adequately to limit local transmission. Furthermore, it is important for health leaders to have a ‘global outlook’, which can influence agendas of both international and national government all the way down to local communities. Crucially, the more that leprosy remains in the public interest, the more media coverage, money and labour will be attracted to research and policy making, developing targeted and effective strategies to achieve elimination. So how can we increase awareness? A multi-pronged approach must be adopted, where governments, hospitals, medical schools, nursing colleges and students need to ensure that healthcare professionals are aware of the global burden of leprosy. Organisations like Lepra should be lobbying the government and national organisations like the General Medical Council (whose role it is to specify the requirements of a medical curriculum) to make sure that doctors trained in this country are ‘global doctors’, who understand the pathology and implications of neglected diseases like leprosy. I became passionate about the cause of neglected tropical diseases, and particularly leprosy, by travelling to Nepal in the summer after my first year to complete a placement in Lalgadh Leprosy Centre. This was partly funded by St Francis Leprosy Gild. I think these placements are invaluable experiences for students and doctors, not only to learn about different health systems, but also to become ambassadors for people affected by leprosy in the UK. I developed my interest by becoming an editor for Polygeia, a student-led global health think tank based at the University of Cambridge. I worked on a project commissioned by Lepra on the disproportionate impact that leprosy has on women, which was presented at the annual conference and heard by students and global health leaders. I think it is crucial for Lepra to engage student societies in this way, to encourage discussion and promote high quality research and policy making. Making Lepra known to university based fundraising organisations, such as RAG (Raising And Giving) would also be beneficial, not only in raising more money, but also in exposing leprosy to a very wide student network. Of course, the importance of interacting with medical students and health professionals on all social media platforms cannot be understated. Together these multiple approaches will not only keep leprosy in the public arena, but will also inspire individuals to encourage national and international governmental organisations to create policy and to keep funding and raising awareness of neglected tropical diseases like leprosy, making elimination a more achievable goal.