The prevention of disability for people affected by leprosy: whose attitude needs to change?

This paper reflects on the current emphases in the domain of prevention of disability (POD). A review of literature is presented and issues relating to the challenges that affect POD, in the changing scenario of services for leprosy-affected people are considered. A notable conclusion is that the preservation of peripheral nerve function is primarily dependent on early detection; due to challenges that may compromise that essential service, it is suggested that a sharper focus needs to be given to interventions that prevent secondary disabilities. The paradox of pragmatic and simple interventions is that they are difficult to implement. The main issue is that there is a requirement for a commitment to a fundamental change in the relationship between health providers (at all levels) and recipients.