Addressing inequality and exclusion – the opinion of people affected by leprosy in Africa and Asia, as to what should be included in any post Millennium Development Goal framework

Abstract

The Millennium Development Goals (MDGs), international targets set in September 2000 by 189 nations, commit to working towards a measurable reduction in poverty and achieving basic needs and rights for all, by 2015. The UN Declaration (UN General Assembly Resolution 55/2, United Nations Millennium Declaration) on which the MDGs were based upholds the principles of human dignity, equality and equity. It states that every individual has the right to a basic standard of living that includes freedom from hunger, violence, oppression and injustice. However, although the Declaration highlights the need to ensure that the most vulnerable are included in the development process, the lack of specific reference to leprosy, neglected tropical diseases or disability has meant that some of the world’s most marginalised people have not been included in development programmes. The UN recognises that ‘there is an urgent need to address the absence of more than 10 per cent of the world’s population in the implementation, review and evaluation of the Goals and their targets, evaluation mechanisms and indicators. The lack of a disability perspective is undermining the objective of the Goals, which is to measure human development benchmarks on the way to more inclusive and equitable global development.’ More than one billion people are still affected by the chronic disabling results of Neglected Tropical Diseases, particularly those living in remote rural areas, urban slums or conflict zones. 232,857 new cases of leprosy were reported in 2012, an increase on the previous year and millions of people still suffer the physical, social and economic consequences of the disease. Disability and stigma mean many people affected by leprosy are socially excluded, and fail to benefit from mainstream development programmes. As development becomes a numbers game and measures of success are confined to MDG indicators, gaps between the rich and the poor grow. Oxford research on the