A/HRC/44/46/Add.1 there were 98 new foreign-born cases, most of them from Nepal, the Philippines and Brazil, and 34 new Japanese cases, 20 of which were from Okinawa prefecture. 5. The incidence of Hansen’s disease started declining after the introduction of the first available medical treatment for the disease in 1946,2 then fell drastically in the 1970s. Until as late as the twentieth century, the modern history of Hansen’s disease in Japan involved multiple human rights violations. After the Meiji Restoration in 1868, the development of a national identity together with a drive towards modernization led to the institutional exclusion of persons affected by Hansen’s disease, which dehumanized them, robbing them of their personal identities and rights. 3 6. In 1907, the first leprosy prevention law was enacted to isolate persons affected by Hansen’s disease. That policy was subsequently reinforced through laws passed in 1931 and 1953. It is striking that the second of those laws was passed in the same year as the international community, including Japanese scientists and medical doctors, gathered at the sixth International Leprosy Congress, held in Madrid, 4 and agreed to abandon the policy of segregation, which had emerged as a global policy in the late nineteenth century. Prior to the enactment of the 1953 leprosy prevention law, medical doctors operating in the field, who were aware of the international trend away from that policy, were consulted by the House of Representatives (the National Diet) and recommended continuing with the policy of segregation. Even more striking is the fact that this law remained in force until 1996. 7. The formal discrimination provided for under that law constituted a systemic violation of the human rights of persons affected by Hansen’s disease, accompanied by torture, inhumane treatment and abuse of different sorts. These included breaking family ties, forced labour within the confinement settings, often resulting in the worsening of physical impairments, and the most extreme violation of the right to the continuity of life in the form of forced sterilization (eugenic surgery), which was permitted in 1948 under the eugenics protection law. 8. Today, there are still about 1,200 persons affected by Hansen’s disease living in sanatoriums in Japan. Their average age is 86 years old. A considerable number of people have left the sanatoriums. They now constitute an ageing population that is living with physical and psychosocial impairments and disabilities related to Hansen’s disease, many of which are very serious. They include visible physical impairments, such as irreversible damage to the skin, nerves, hands, feet, limbs and eyes, and disfigurement, blindness, loss of sensation, chronic wounds and neuropathic pain. Many of these impairments and disabilities are aggravated by conditions related to old age, such as orthopaedic diseases, metabolic syndromes, cancer, depression and loss of cognitive functions. III. Legal and institutional framework 9. The Japanese Constitution is based on the principle of popular sovereignty and on respect for fundamental human rights. In its preamble, the Constitution affirms the preservation of peace and acknowledges the right of everyone to live in peace, free from fear and want. Article 13 of the Constitution provides that all people shall be respected as individuals. Article 11 provides that people shall not be prevented from enjoying any of the fundamental human rights and article 14 provides that all people are equal under the law and that there shall be no discrimination. Pursuant to article 25, the State shall strive to promote and improve social welfare and security, and public health. Article 98 affirms that the Constitutional is the supreme law of the nation and that Japan is obliged to implement the international treaties it has ratified. Pursuant to article 98 (2), the provisions of the international treaties ratified by Japan are juridically framed as part of domestic law. 2 3 4 G.H. Faget and others, “Present status of promin treatment in leprosy”, International Journal of Leprosy, vol. 14, No. 1 (1946). Fujio Ohtani, The Walls Crumble: The Emancipation of Persons Affected by Hansen’s Disease in Japan (Tokyo, Tofu Kyokai Association, 1998). Memoria del VI Congreso Internacional de Leprología: Madrid, octubre de 1953 (Madrid, Gráficas González, 1954). 3