Publications

Leprosy is an infectious disease caused by Mycobacterium leprae and is endemic in many developing countries. The World Health Organization (WHO) has adopted the goal of eliminating leprosy as a public health problem by the year 2005, defined as reducing the national prevalence below 1/10 000.1 Until now, the prevalence decreased mainly due to the introduction and subsequent shortening of multidrug treatment (MDT). Leprosy control strategies are designed to stop transmission through early case detection and treatment with MDT, but do not seem to have the desired effect. The number of new cases—719 330 in 20002—did not decline over the last 15 years, indicating that transmission is continuing at the same level.

Important developments have taken place over the past decade in tackling the global leprosy burden. There has been a very significant reduction of over 90% in the total number of leprosy patients registered for treatment through the implementation of multidrug therapy regimes that have dramatically reduced the duration of treatment. However, despite this reduction in registered prevalence of leprosy, there has been no parallel reduction in the global case detection. This is a serious barrier to aspirations to eradicate leprosy in the future.

For many years, official development assistance (ODA) to low and middle income countries seemed incompatible with private sector initiatives. ODA had its roots in charity while the private sector was looking for profits. ODA interests were on the side of recipients; the private sector’s interests were on the side of shareholders.

The conference ‘Governing for Equity’ was the outcome of a process in which many individuals and institutions have been involved over a period of three years beginning in 1999. In that year KIT Gender, at the Royal Tropical Institute in Amsterdam, initiated a three-year programme entitled ‘Gender, Citizenship and Governance’.

A landlocked Sahelian country, Burkina Faso has an estimated population of
around 12 million inhabitants and covers 274 000 km2. Its location presents considerable challenges for the economic development of the country. The climate can be classified as Sudanese, with two contrasting seasons, a rainy and a dry season lengthening into the more northern reaches of Burkina. Rainfall varies from one year to another and droughts can take a heavy toll on agricultural production, which is the mainstay of the Burkinabé economy.

Many Ministries of Health are trying to improve the functioning of their health care system by introducing changes in resource allocation, better management and changes in the role of the government, such as more responsibility at lower levels through decentralisation. A prerequisite of a well-functioning system is a well-motivated workforce. The Ministry of Health in Viet Nam gives great importance to the development of a public health network, in order to provide good quality health care services. As most people live in rural areas, an extensive public health network is required in rural areas so as to provide appropriate care close to the people. This implies the need to keep sufficient qualified and motivated human resources in the rural areas.

Over the past several years the HIV/AIDS pandemic in Africa has been recognized as being more than simply a health issue. HIV/AIDS impacts every sector, including education. In the high HIV-prevalence countries of southern and eastern Africa, the education sector is currently being hit by massive teacher shortages due to death, absenteeism, and attrition as teachers fall ill, care for sick family members, or fill vacancies in other fields. At the same time, the needs of learners are changing as young people must learn at an earlier age how to protect themselves from HIV/AIDS and care for affected family members and friends.

Mainstreaming a gender perspective in development was the overall strategy adopted at the Fourth UN Conference for Women, held in Beijing in 1995, to support the goal of gender equality. The rationale for this strategy is that it is important to bring the goal of gender equality to the centre of the development process. After three decades of gender and development activism, most in development institutions continue to need constant reminders of the need for gender analysis in their work. Why is it that policy makers still have to be lobbied to include the g word, and colleagues need to be convinced that integrating a gender analysis in their work makes a qualitative difference?

Agricultural research and extension in sub-Sahara Africa have been subject to repeated organisational and institutional reforms during the last few decades. Donors and central governments were the main drivers of reorganisation and re-structuring processes. Mostly “blueprints” based on “western” models were applied; although sometimes a perceived lack of impact was given as the rationale, the actual reasons for change were often of an ambiguous nature.

Au cours des dernières décennies, la recherche et la vulgarisation agricole en Afrique subsaharienne ont connu d’importantes réformes institutionnelles et organisationnelles. Les bailleurs de fonds et les Gouvernements nationaux étaient les principales forces de réorganisation et de restructuration.

A literature review was conducted to review work done to date on measuring stigma related to leprosy. References were obtained through a PubMed (Medline) search and through examining relevant bibliographies. Twelve papers were selected that addressed the issue of measurement of stigma and that contained a sample of the instrument used. Three unpublished studies were also included in the review

This study was designed to investigate whether leprosy patients diagnosed with mild sensory impairment have a better prognosis when treated with steroids than similarly impaired patients treated with placebo.

A ‘disability classification’ for use in leprosy has been advocated by who since 1960. Two revisions of this grading system were subsequently published, a 4-point scale in 1970 and a 3-point scale in 1988.