Sustainability in fighting leprosy Revitalising high ambitions

The last three decades brought a tremendous and hard-to-overrate success in fighting leprosy, thanks to the impressive co-operation of various highly committed actors from civil society, government, and the private sector. As the last mile is always the hardest to go, a fresh and future-oriented debate about sustainability is a highly desirable initiative at this point in the campaign against this disease. Having been asked for some thought-provoking remarks from the perhaps unusual perspective of a ‘think tank’ in international health and corporate responsibility (which is one of the functions of the Novartis Foundation for Sustainable Development), it is tempting to start with the origins of the vogue term ‘sustainability’, which once told foresters to plant enough young trees when harvesting old ones so that a stable population would result. Of course, a stable number of new leprosy cases is definitely nobody’s intention when talking about maintaining the quality and coverage of leprosy services. Anti-leprosy work keeps aiming at rapidly pushing the disease further and further back. Thus, in this context sustainability has the curious notion of not making exactly the same efforts as in the past. Future success depends on changing, not preserving, familiar patterns and approaches. But it is clear that considerable resources are needed – and that there is a built-in tendency today to lose resources. During the ecology debate of the seventies, the term ‘sustainability’ became omnipresent, particularly in the economic realm. Today annual reports and websites of most big companies and many smaller enterprises refer to sustainability, often using terms like corporate citizenship or corporate social responsibility synonymously. For the anti-leprosy community, the interesting point of these efforts is the underlying notion of sustainable decisions being built on a clear sense of feasibility as well as a strong goal of responsibility – always considered from the different points of view of various stakeholders.