Leprosy has long been extinct in Europe, but in parts of Asia, Africa and Latin America, it is still destroying many lives.
Anyone travelling around New Delhi and any of India's megacities is bound to come across victims at the main crossroads.
They knock on the windows of queuing cars and beg for a few rupees. Dressed in dirty rags, some are missing a finger or two while others no longer have hands or feet. Some of their faces are disfigured.
Their lives have been devastated by leprosy, leaving them reliant on the modest alms.
World Leprosy Day on Sunday is aimed at drawing attention to the disease, which infects more than 120 000 people every year in India. Worldwide, twice as many victims fall ill with it.
Surveys by the World Health Organisation and governments indicated a decrease in the number of victims in recent years. India's National Leprosy Eradication Programme also said it has had success fighting the disease. But others urged caution.
"Even in India, official statistics give the impression that the problem is receding," said Rajbir Singh, a representative of the German Leprosy and Tuberculosis Relief Association, which has been active in the country for more than 50 years.
"Yet, our surveys show that the number of new infections is still high in some regions," he said.
They included poor states such as Bihar and Chhattisgarh in the east as well as the Dadra and Nagar Haveli union territory in the west.
'The poor people's disease'
Leprosy has been treated successfully since the 1980s with a mix of three antibiotics that have to be taken over several months.
"At the time, we had hoped to bring the disease under control, but unfortunately, that did not work out as we still lack in-depth knowledge about how it spreads," said Burkhard Koemm, the German association's manager.
Koemm said more funds are needed for additional research.
Leprosy is spread from person to person. Cramped, dirty living conditions like those in India's large slums are breeding grounds for the disease and increase the risk of contracting it. Malnutrition and dirty drinking water coupled with a weakened immune system do not help, prompting many experts to dub leprosy the "poor people's disease".
"The victims' standard of living makes it hard to diagnose and cure," Singh said.
Many are so busy just trying to survive each day that they do not notice the first signs of leprosy, such as discolorations of the skin. They only seek help when their hands and feet have gone numb and the risk of serious injuries has soared.
Early diagnosis crucial
But it's often too late by then because even if antibiotics do work, the central nervous system has been irreparably damaged and the victims will be disfigured for the rest of their lives, the doctor said.
"Early diagnosis is a must, which is why campaigns to educate people are one of the top priorities of our work across the country," Singh said.
These campaigns are in addition to the German association's programmes giving medical treatment to victims of leprosy-induced deformities and reintegrating them into the workforce. About 30 000 Indians benefited from these programmes in 2011.
Singh said obvious, physical deformities make it difficult for former patients to pick up their lives again. They are often stigmatised and become outsiders because many people in India are still terrified of contracting the disease.
"People no longer throw stones at the victims," Singh said. "Yet despite our efforts to inform people, an impartial approach to leprosy is still a long way off."
- (Stefan Mentschel, DPA/Sapa, January 2012)
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