Repealing an outdated law

Malta takes a stand against leprosy stigma.

A law from a bygone era, a time when fear and misunderstanding ruled. A law that segregates and discriminates against people on the basis of what is now a treatable disease. This is the reality for some countries, including Malta, where the Lepers Ordinance, a relic of the colonial past, remains in effect. But change is coming.

Tonight, Parliament’s Consideration of Bills Committee will discuss the repeal of this outdated legislation, a move championed by Julia Farrugia Portelli, Minister for Inclusion, Voluntary Organisations, and Consumer Rights. The First Reading of the Lepers Ordinance and the Lepers Regulations (Repeal) Bill took place on the 8th May and the Second Reading on 26th June.

What is leprosy?

The World Health Organisation (WHO) defines leprosy, also known as Hansen’s disease, as a chronic infectious disease caused by Mycobacterium leprae. The disease affects the skin, the peripheral nerves, mucosal surfaces of the upper respiratory tract, and the eyes. Leprosy is known to occur at all ages ranging from early childhood to old age. It is curable and treatment during early stages can prevent disability. Leprosy is transmitted via droplets, from the nose and mouth, during close and frequent contact with untreated cases.

While leprosy itself can cause physical disabilities, the significant stigma surrounding the disease creates additional social barriers. This can effectively disable individuals even in the absence of physical limitations.

Has leprosy been eradicated?

Leprosy is not completely cured around the world, but it is nowadays considered highly treatable. Thanks to advances in modern medicine, spearheaded by the WHO, the global approach to leprosy has transformed. Significant progress has been made in tackling transmission and improving recovery outcomes.

In 1982, the WHO endorsed the multi-drug therapy (MDT) as a cure for leprosy. This treatment not only heals patients, but also renders them non-infectious within 72 hours.

Leprosy diagnosis and treatment no longer require quarantine. People with leprosy can be treated effectively while living at home with their families, posing no risk to those around them.

Does leprosy still exist in Malta?

Leprosy is considered eradicated in Malta for the native population. The ‘Malta Project’, a leprosy eradication programme that concluded in 1999, laid the groundwork for the first successful leprosy cure. This Maltese initiative significantly advanced the fight against the disease on the islands.

A paper published in the Malta Medical Journal in 2021 (‘Leprosy in Malta: Not to be forgotten’, by Monique Cachia, Alicia Dimech, Alexandra Betts, Charles Mallia Azzopardi, and Michael J. Boffa) states that, in view of the influx of migrant populations over the years, leprosy is starting to be encountered in Malta among nationals of countries where the disease is still endemic.

What are the Lepers Ordinance (Cap. 45) and the Lepers Regulations?

Drafted during a time when leprosy posed a significant public health threat due to its high transmission rate and lack of effective treatment, the Lepers Ordinance, a product of Malta’s British colonial period, aimed to control the spread of the disease. It limited immigration of individuals with leprosy and enforced quarantine procedures upon their arrival.

Further details regarding patient care were established through the Lepers Regulations, enacted under the Ordinance. These regulations designated the Lazaretto on Manoel Island as the official leprosy hospital and created a Leprosy Board to supervise the treatment provided there.

Why are they being repealed?

At last year’s Conference of States Parties to the UN Convention on the Rights of Persons with Disabilities in New York, representatives from the international NGO The Leprosy Mission brought to the attention of Maltese delegates that Malta’s Lepers Ordinance remains in effect. They urged Malta to follow the growing number of countries repealing such outdated legislation.

Minister Farrugia Portelli with representatives of The Leprosy Mission in New York. Photo: The Leprosy Mission.

it is worth mentioning that the former leprosy hospital (Lazaretto) in Malta is now abandoned, and the Leprosy Board has been dissolved.

Will current health protocols be affected?

Repealing this outdated legislation won’t impact current protocols followed by local health authorities. People suspected of having leprosy can still be referred to the Infectious Diseases Unit at Mater Dei Hospital, as necessary. This aspect of patient care remains unaffected by the repeal.

Even an unused law can perpetuate stigma. By removing the Lepers Ordinance, the government is sending a strong message of inclusion and equality for those affected by leprosy.

Is Malta also taking initiatives in the international sphere?

Definitely. Last month in New York, while leading the Maltese Delegation, Minister Julia Farrugia Portelli had a productive bilateral meeting with The Leprosy Mission. Their senior officials expressed gratitude for Malta’s efforts in bringing the repeal of the Lepers Ordinance before Parliament. The NGO recognised Malta’s progress as a best practice example. They are sharing this information with other governments, particularly those like Singapore, that still have discriminatory leprosy laws.

The Maltese government further pledged to collaborate with Commonwealth colleagues to urge other countries with similar outdated laws to reconsider. This initiative began in New York during a bilateral meeting between Minister Farrugia Portelli and her Australian counterpart. Maltese and Australian technical teams are already in communication, and Malta is assisting the Australian government in engaging with this international effort.

Main photo: Joseph Goupy (1689-1769), “A View of the City of Malta, on the side of the Lazaretto or Pest-House, where Ships perform Quarantine”, on display at MUŻA.

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