Leprosy 2013 – The Problem and the Solutions

Leprosy – still a problem? The answer is yes. Every year, an estimated quarter million people worldwide – mostly in Africa, Asia and Latin America – are diagnosed with leprosy, a cruel disease that leaves its victims maimed, crippled, disfigured and blind, often with terrible quality of life. Sunday, Jan. 27, is set aside as World Leprosy Day, when we bring attention to this problem.

While the severity of leprosy is reflected all over the globe, it’s an ignored problem in many respects.

This long-term, destructive and debilitating illness has serious consequences in addition to death. Leprosy’s victims often lead lonely and isolated lives, because of the stigma attached to the disease – a stigma that is often affixed to the entire family.

The number of new cases of leprosy has declined in some areas over the past 15 or so years, thanks to a new multi-drug treatment that the World Health Organization is providing at no cost. But barriers to eradication of the disease remain.

One impediment is the lack of reliable diagnostics and the prolonged course of drugs required for cure. Patients frequently neglect the required 6-12 month course of treatments, often because one of the drugs causes severe, stigmatizing skin discoloration during the span of the therapy. And there is no vaccine for leprosy.

So, the most important thing IDRI can contribute is new tools to enable early detection and treatment of infection. This would help avoid stigmatization, as well as progression of the disease.

To enable tools for elimination, IDRI has approached the problem in two different ways.

• First, by developing a fast, easy diagnostic test (the current method is inadequate and lengthy, by clinical and/or microscopic assessment) that has just been registered for use in Brazil with our partners, OrangeLife. Our goal is to diagnose up to a year before signs are visible so treatment can start before nerve damage occurs.

• Second, by developing a vaccine that can immunize people against leprosy, while also providing treatment to those who have been exposed to the disease but are not yet showing symptoms.

I look at 2013 positively. We have better treatments that are getting even better, and we are confronting leprosy in a strong and smart way. And, our partners and funders at American Leprosy Missions are helping shine a spotlight on the need for new solutions to this age-old problem, especially as we approach World Leprosy Day.

We believe in end-to-end solutions to combat global disease. That means early, rapid and inexpensive diagnosis and detection; safe and effective treatment; and well-tolerated, immunogenic and long-term protection. All of these approaches are needed to take on leprosy and end the pain that’s associated with this disease.

Author: Steve Reed

Steve Reed is the founder, president and chief scientific officer of Seattle-based IDRI. He co-founded Seattle-based Immune Design, a startup vaccine developer. Previously, Dr. Reed co-founded Corixa Corporation in 1994, where he served as Chief Scientific Officer until leaving in 2004. His academic appointments include Professor of Medicine at Cornell University Medical College in New York and Research Professor of Pathobiology at the University of Washington. He serves on several editorial review committees, has served as a member of the Tropical Medicine Review Board of the National Institutes of Health, and is a member of the Vaccine Development Steering Committee of the World Health Organization. Dr. Reed was born in rural eastern Washington, graduated from Whitman College in 1973, and received a Ph.D. in Microbiology and Immunology from the University of Montana in 1979. That year he was appointed as Scientist of the National Institute of Amazon Research in Manaus, Brazil, where he directed research on tropical diseases. Dr. Reed joined Cornell University Medical College in 1980 as Assistant Professor of Medicine, continuing to work in Brazil as manager of the Cornell-Bahia program in International Medicine. He joined the Seattle Biomedical Research Institute in 1984 where he worked until founding IDRI in 1993. Dr. Reed’s research interests have focused on the immunology of intracellular infections, and on the development of vaccines and diagnostics for both cancer and infectious diseases. He has more than 170 original articles, several book chapters, and holds 59 issued patents for diagnostics, vaccines, and therapeutics of infectious diseases and cancer.