Prospects for sustaining leprosy control in Uganda

The Uganda Ministry of Health launched a National Tuberculosis and Leprosy Programme (NTLP) in 1990. The programme functions at three levels: Central, Zonal (intermediate) and District. The first 4 years of NTLP saw the change from Dapsone monotherapy and several Rifampicin and Clofazimine containing treatment regimens to World Health Organization (WHO) recommended Multidrug Therapy (MDT). National coverage with MDT was achieved in 1994. At the time of starting NTLP there were over 2000 leprosy patients on treatment and following introduction of MDT the numbers of registered cases declined dramatically while the number and rate of new cases notified especially the Multibacillary (MB) type showed a more gradual decline (see Figure 1). The country achieved the target of elimination of leprosy in 2004. In 2006 Uganda adopted the WHO Strategy for further reducing the burden of leprosy and sustaining leprosy control services. According to the strategy, quality is one of the essential components of an effective programme. The quality and coverage of a programme are key determinants of its sustainability. This paper presents a review of the performance of the Uganda National Leprosy Control Programme in terms of quality services as defined in the Operational Guidelines of the Enhanced Strategy and suggests steps to take in order to ensure sustainability of quality leprosy control services in the country.