On November 4, 2024, Counsellor Dr. Michael Espiritu delivered a statement at the United Nations General Assembly Third Committee on the topic of the Elimination of Discrimination Against Persons Affected by Leprosy (Hansen’s Disease) and their Families.

Opening the session, Ms. Beatriz Miranda Galarza, Special Rapporteur on the Elimination of Discrimination Against Persons Affected by Leprosy, presented her report. She emphasised that care for persons affected by leprosy has historically been medicalised and framed within institutional settings, often overlooking the human and social dimensions that significantly impact their quality of life.

Ms. Miranda Galarza highlighted the unique challenges faced by women, children, and older persons affected by leprosy. Women, she noted, frequently shoulder caregiving responsibilities under conditions of unpaid and undervalued labor. Many not only manage their illness but also care for family members affected by leprosy or other chronic conditions. This caregiving burden, compounded by cultural expectations, limits their access to education, employment, and financial independence, placing a strain on their health and well-being.

Quoting one woman affected by leprosy she had spoken with, Ms. Miranda Galarza shared, “Society makes people like me believe it is our fault we are affected by leprosy, and that it is also our responsibility to take care of our families. How can we look after our families when no one looks after us?”

Children, she added, often face exclusion from schools and social activities, which hampers their development. Many also encounter barriers in accessing timely medical care and treatment. Older persons affected by leprosy navigate chronic conditions with limited social and family support. Those living in former leprosy settlements frequently experience isolation, financial insecurity, and inadequate access to basic health and rehabilitation services.

Ms. Miranda Galarza’s report proposed a human rights-based framework for rethinking care and support systems. She underscored the importance of good governance, calling on states to establish participatory frameworks that include persons affected by leprosy in the design, implementation, and evaluation of care systems. Such frameworks must uphold principles of transparency, equality, and sustainability.

She also advocated for comprehensive social protection systems that extend beyond health services. These systems, she argued, should provide financial assistance for medication and mobility aids, alleviating the financial and caregiving burdens on families and promoting social inclusion.

Addressing the multifaceted challenges faced by persons affected by leprosy, Ms. Miranda Galarza stressed the need for multi-sectoral collaboration and the inclusion of affected individuals in identifying their physical, social, and mental health needs. She called for a well-trained and empathetic workforce to provide reliable support, highlighting the critical role of family caregivers, particularly women.

Ms. Miranda Galarza emphasised the need for sustainable care systems, which require prioritising funding for support services that uphold the dignity of affected individuals. She advocated for multi-sectoral financial models involving public and private sectors, civil society, and international organisations.

She concluded by underscoring the importance of ethical care, which affirms the dignity and agency of persons affected by leprosy. Compassionate policies that consider cultural and religious contexts, she said, are essential for achieving truly person-centered care.

Ms. Miranda Galarza urged member states to adopt comprehensive policies addressing all aspects of leprosy care and integrate these into broader social protection systems. “Only by recognising the agency and expertise of persons affected by leprosy,” she concluded, “can we ensure a just, equitable, and human future for all.”

In his statement, Dr. Espiritu emphasised how leprosy remains a pressing global issue, with over 200,000 new cases annually, highlighting that the work to eradicate its effects is far from complete. He added that, beyond physical health challenges, the disease inflicts significant social suffering, as individuals affected and their families face severe stigma and discrimination, leading to exclusion from public spaces, denial of education, social isolation, and economic marginalisation.

Dr. Espiritu stressed that failing to address these injustices undermines global commitments to human rights and the Sustainable Development Goals, which prioritise dignity, equity, and inclusion.

Dr. Espiritu drew attention to the Sovereign Order of Malta’s comprehensive efforts in combating leprosy which include health interventions such as screening, treatment, surgical care, rehabilitation, and training for care providers. He highlighted that the Order’s initiatives also address social reintegration and work to eliminate stigma. Dr. Espiritu shared details of how, in Vietnam’s Central Highlands, the Order provides transportation to ensure access to healthcare for persons affected by leprosy, counteracting the social barriers caused by discrimination.

Dr. Espiritu concluded by advocating for holistic responses to leprosy that address both medical needs and the broader challenges of social exclusion and discrimination, essential for improving lives and achieving the SDGs.