Abolition of leprosy isolation policy in Japan: policy termination through leadership

The termination of a policy is often considered an important step for correcting existing policies and allocating resources efficiently. Scientific advances, for example, may make the existing policy obsolete and unjustifiable. Delay in terminating a flawed policy may result in increasing its harm. In many cases, however, it is suggested that inertia and other obstacles must be overcome before a termination can be accomplished. Health policy is no exception to these findings. The isolation of leprosy patients, a practice introduced early in this century, was maintained in Japan even after it proved scientifically unnecessary. It was only after a few decades of inertia and political struggles that the policy was abolished. As can be seen in previous studies in the other domains, a set of obstacles, such as intellectual reluctance, opposition of vested interests, and bias in expert opinions, existed, and hampered the timely termination of the isolation policy. Over a long time, policy adaptation was gradually made in practice through the loose administration of policy. It was only by the leadership of a skillful terminator that the issue was finally brought to the forefront, consensus achieved among key actors, and the policy abolished.
Public policy termination can be defined as the deliberate conclusion or cessation of specific government functions, programs, policies, or organizations (Brewer & deLeon, 1983; deLeon, 1978a). That termination is deliberate [...]