04795nas a2200109 4500000000100000008004100001100007200042245007900114856008300193520438700276020002204663 2021 d 1 aWorld Health Organization, Regional Office for the Western Pacific 00 aEpidemiological review of leprosy in the Western Pacific Region: 1983-2018 uhttps://iris.wpro.who.int/bitstream/handle/10665.1/14710/9789290619383-eng.pdf 3 aSince the adoption of World Health Assembly resolution WHA44.9 in 1991, great progress has
been made in the fight against leprosy. However, the historical trends and the current situation for
leprosy epidemiology vary substantially across countries in the World Health Organization (WHO)
Western Pacific Region. This report, Epidemiological Review of Leprosy in the Western Pacific Region
1983–2018, presents all available historical data for all countries and areas of the Region from1983 to 2018,
together with programmatic and policy milestones. It was developed by compiling leprosy surveillance data
reported annually from countries and areas in the Region to the WHO Regional Office for the Western Pacific
during this time, which were further reviewed and validated by national leprosy elimination programmes to
ensure consistency with the nationally available data.
The Western Pacific Region accounted for 4% of new leprosy cases worldwide in 2018. The number
of registered cases in the Region decreased by 89.5%, from 68 313 cases in 1991 to 7876 cases in
2018. In 2018, the prevalence rate in the Region was 0.04 per 10 000 population, which was six
times lower than the global average. The highest prevalence rate was found in Kiribati with 18.6
per 10 000 population, followed by the Marshall Islands with 11.0 per 10 000 population and the
Federated States of Micronesia with 10.7 per 10 000 population. The highest number of registered
cases was reported in the Philippines with 4970 cases, followed by China with 970 cases and
Papua New Guinea with 626 cases. In 2018, countries and areas for which the prevalence rate was above the
elimination level included the following six: American Samoa, Kiribati, the Marshall Islands, the Federated
States of Micronesia, Nauru and Tuvalu. The number of new cases detected in the Region decreased by
72.1%, from 15 002 cases in 1991 to 4193 cases in 2018. The countries with the three highest new case
detection rates were Kiribati with 149 per 100 000 population, the Federated States of Micronesia with 113
per 100 000 population and the Marshall Islands with 101 per 100 000 population. Of 37 countries and areas
in the Region, seven countries and areas (18.9%) did not report new leprosy cases in 2018.
Across the Region, the proportion of multibacillary (MB) leprosy cases among total new cases increased
from 69.0% in 1997 to 82.8% in 2018, with wide differences among countries. The number of child leprosy
cases decreased by 62.8%, from 1240 cases in 1997 to 450 cases in 2018. Child cases represented 10.7% of
total new cases in 2018. In 1998, the Region achieved the global target of reducing the occurrence of new
cases with Grade 2 disabilities to less than one case per million population. In 2018, the number of new
cases with Grade 2 disabilities was 258, yielding a rate of 0.13 per million in the Region.
In the past, people affected by leprosy were forcibly quarantined by law in isolated hospitals, sanatoria or
leprosy colonies. Even today, in some countries, people affected by leprosy and their family members may
be directly or indirectly discriminated against in society. Notable areas include marriage, employment, and
the use of public places including hotels, restaurants and transport. The United Nations General Assembly
has adopted a resolution that calls for the elimination of discrimination against people affected by leprosy
and their family members. There is growing international momentum to review the current situation as a first
step toward addressing legal discrimination against people affected by leprosy and their family members. A
regional review of legislation demonstrated that laws that directly or indirectly discriminate against people
affected by leprosy and their family members were in force in the past in some countries and areas of the
Western Pacific Region, and that some remain in effect today, regardless of whether they are enforced.
The WHO Regional Office for the Western Pacific has developed a web-based Leprosy Dashboard that
enables tabulation and visualization of all indicators and data presented in this epidemiological report. The
dashboard is accessible to all and can be customized to suit a user’s preferences. Figures and data generated
by the dashboard can be downloaded. a978 92 9061 938 3