Japanese leprosy patients receive official apology

POLICY AND PEOPLE

Japanese leprosy patients receive official apology US$29·1 million to 127 plaintiffs (see fter rejecting advice from governLancet 2001; 357: 1599). The plainment lawyers, the Japanese prime tiffs had demanded compensation minister, Junichiro Koizumi, apolofor their treatgised to former ment under the leprosy patients Rights were not 1953 Leprosy and ruled out a Prevention Law, challenge to a granted to include this which led to the lower court judgeimage in electronic incarceration of ment that found thousands of patithe state at media. Please refer to ents with leprosy fault for isolating the printed journal. in remote commpatients with lepunities. Many rosy until 1996. women at the lep“The governrosariums were ment seriously Koizumi apologises forced to have reflects and offers abortions and men were sterilised. its frank apology over the pain and The isolation policy was not suffering of the patients and former revoked until 1996, decades after patients”, the popular premier said in most developed nations had ended a statement issued on May 25. “We similar practices because new mediaccept the fact that the policy to put cines could effectively treat the disease leprosy patients in institutions served and studies showed that leprosy was as a major limitation and restriction to not as contagious as previously many patients’ human rights and that believed. there has been extremely severe prejuKoizumi’s decision to overrule govdice and discrimination against such ernment officials has boosted his poppeople among the public.” ularity among an electorate who have Bureaucrats at the health, labour, turned sharply against the country’s and welfare ministry had urged the civil service, which has been blamed prime minister to appeal against a for the economic downturn and May 11 ruling by the Kumamoto disblighted by corruption scandals. trict court that ordered the state to pay AP

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The move is politically astute. Health, labour, and welfare minister Chikara Sakiguchi, a member of the pro-welfare Komei party, had threatened to resign if the government appealed the ruling. By turning down such a legal challenge, Koizumi has strengthened the unity of his cabinet and increased his personal ratings, now at an astonishingly high 86%. The legal fallout from the decision is still to be determined. In an attempt to prevent it from setting a precedent, government officials have issued a statement saying that they still do not accept the legal validity of the Kumamoto court’s decision, but that they will not appeal on humanitarian grounds. Politicians must now begin work on drawing up a compensation package for thousands of other former leprosarium internees. More than 1700 have already launched lawsuits against the state. “The historic ruling confirms we are humans”, Jun Takashi, one of the plaintiffs, told reporters. “Japan is not a nation governed by bureaucrats who always insist on appealing rulings.” Jonathan Watts

News in brief

Mixed emotion after first Japanese surrogate birth

Call for AIDS vaccine The International AIDS Vaccine Initiative (IAVI) will ask world leaders to put more resources into the development of an AIDS vaccine at the UN General Assembly Special Session on HIV/AIDS (June 25–27; New York, NY, USA). IAVI will ask world leaders to commit new funds, which must not be diverted from other health-care programmes, and must include binding commitments for financing the purchase and delivery of vaccines to developing countries. Governments must find “innovative ways to assure global access to AIDS vaccines while allowing a reasonable return for industry’s investments”.

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Polio in Europe WHO announced on May 22 that it has detected two new cases of polio in Bulgaria. The cases, a 13-month-old gypsy boy in Burgas and a 2-year-old gypsy girl in Yambol region of Bulgaria, are the first cases in Europe since 1998. The laboratory findings traced the polio virus to India.

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he first surrogate birth in Japan has sparked a national debate about the government’s policies on reproductive medicine. Health, labour, and welfare minister, Chikara Sakiguchi, urged parliament to enact a law banning surrogate births in response to reports that a woman carried a baby to term for her elder sister at the Suwa Maternity Clinic in Shimosuwa, Nagano prefecture earlier this year. The woman, whose name has been withheld, was implanted with an egg from her sister that was fertilised in vitro with the sister’s husband’s sperm. The birth challenged a health ministry recommendation in December that surrogacy should be prohibited because it “uses women”. But the doctor who did the procedure defended his actions. “We should use a surrogate mother as long as all parties involved are in agreement”, said Yahiro Netsu. “If I had ignored the woman’s request to serve as a surrogate mother for her sister, I would

have violated human ethics.” Netsu is no stranger to controversy. In 1998, he was the first doctor to be expelled from the Japan Society of Obstetrics and Gynaecology after he ignored the society’s guidelines by using in-vitro fertilisation to help a woman become pregnant with twins using her sister’s ova. The Japanese cabinet appears to be split over the issue. “I have doubts about the advisability of a total ban on surrogate births because they can meet a heartfelt desire for having a child without causing trouble”, said science and technology minister, Koji Omi. Most newspaper editorials, however, urged caution. “The fait accompli of the birth is unfortunate because it comes as experts are formulating legislation on reproductive medicine”, said the mass circulation Yomiuri Shimbun national daily newspaper. “The nature of surrogacy stirs up complex social and ethical issues.” Jonathan Watts

THE LANCET • Vol 357 • June 2, 2001