A/HRC/38/42 I. Introduction 1. In its resolution 35/9, the Human Rights Council established the mandate of the Special Rapporteur on the elimination of discrimination against persons affected by leprosy and their family members. In the resolution, the Council recognized that, in various parts of the world, persons affected by leprosy and their family members continue to face multiple forms of discrimination and widespread barriers to their participation as equal members of society, including isolation, discrimination and violations of their human rights. The adoption of the resolution was aimed at intensifying efforts to eliminate all forms of prejudice and discrimination against persons affected by leprosy and their family members and to promote policies that facilitate their inclusion and participation. 2. The resolution mandates the Special Rapporteur to report annually to the Council, starting from its thirty-eighth session. Following the adoption of the resolution, the Council appointed Alice Cruz to lead the mandate. She assumed her duties on 1 November 2017. In the present report, the Special Rapporteur introduces leprosy and details her vision, priorities and working methods for the next three years. II. Leprosy A. A curable disease 3. Leprosy, also known as Hansen’s disease, is a chronic infectious disease caused by Mycobacterium leprae. Leprosy has a long incubation period and symptoms may appear between 2 and 20 years after infection. Leprosy can occur from early infancy to very old age. The disease mainly affects the skin, the peripheral nerves, the mucosal surfaces of the upper respiratory tract and the eyes. 1 4. Contrary to the social representation of leprosy as a highly contagious disease, leprosy is not highly infectious, and most persons (around 95 per cent) who are in contact with the disease do not develop it. In fact, most people are naturally immune to leprosy. The mechanism of transmission is not yet clear. However, leprosy is most likely transmitted through droplets, from the nose and mouth, and during close and frequent contact with untreated cases.2 5. Leprosy is curable with a combination of drugs known as multidrug therapy. The treatment of leprosy with only one drug can lead to drug resistance. The combination of drugs depends on the classification of the disease. Rifampicin, the most important drug, is included in the treatment for both types of leprosy (paucibacillary and multibacillary). Multidrug therapy has been supplied free of charge by the World Health Organization (WHO) since 1995. Multidrug therapy was donated until 2000 by the Nippon Foundation. Since then, it has been donated by Novartis and will continue to be so until 2020. The elimination of leprosy as a public health problem (defined as a registered prevalence of less than 1 case for every 10,000 persons) was achieved globally in 2000.3 6. However, the global elimination of leprosy as a public health problem may hide the fact that there are still highly endemic countries, as well as highly endemic pockets within countries. The drastic decline in the prevalence of leprosy in the last three decades has not meant that leprosy has disappeared. In fact, there is still ongoing transmission. 7. Stigmatization and discrimination remain major obstacles to the elimination of leprosy, a fact that has been agreed upon by the main stakeholders. In 2010, the General Assembly adopted resolution 65/215 on the elimination of discrimination against persons affected by leprosy and their family members and took note of the principles and guidelines 1 2 3 See www.who.int/en/news-room/fact-sheets/detail/leprosy. Ibid. Ibid. 3