Leprosy in India: Challenges Ahead

Introduction to Leprosy in India

India has made significant progress in reducing the prevalence of leprosy over the last decade, with the national prevalence dropping to under 1 case per 10,000 people by 2005. However, the continued transmission of the disease in many pockets constrains India's ability to meet targets outlined in the National Strategic Plan (NSP) and Roadmap for Leprosy 2023-2027.

The World Health Organization (WHO) declared that India had “eliminated [leprosy] as a public health problem” in 2005, but the government became complacent and allowed the folding of the leprosy surveillance programme into the general health system. This led to a rise in disability due to leprosy in the early 2010s, prompting door-to-door screening.

Historical Context of Leprosy in India

Leprosy, also known as Hansen's disease, has been a significant public health problem in India for centuries. The disease has been prevalent in many parts of the country, with some areas having higher rates of transmission than others. In the past, leprosy was often associated with stigma and social exclusion, making it difficult for those affected to access medical care and other services.

Current Status of Leprosy Elimination in India

Today, the NSP is focused on cutting transmission, in line with WHO. The programme has made significant progress, with workers screening more than 70 crore people in highly endemic areas in 2025-26, detecting 24,367 cases, and ASHA workers flagging nearly 40 lakh suspected cases, with 48,027 cases confirmed.

Workers also administered single-dose rifampicin as post-exposure prophylaxis to 91.1% of those 16.9 lakh likely to have come in contact. The government has operationalised digital surveillance and is deliberating on using the MIP vaccine to accelerate pathogen clearance in patients deemed highly infectious.

Challenges Ahead in Leprosy Elimination

Despite the progress made, there are still significant challenges ahead. The drop in disease burden has been highly uneven, with states like Chhattisgarh, Jharkhand, Odisha, and Maharashtra bearing disproportionate shares of the national burden. According to the 2025-26 National Leprosy Elimination Programme report, only 148 districts have achieved ‘interruption of transmission’ (pending field verification) against the projected 300.

Research has shown that nerve damage in many patients occurs by the time they seek care, largely due to stigma, while many clinical practitioners are unfamiliar with leprosy's pathology or misdiagnose it as a skin condition. The government needs to double down on interrupting transmission and make prevalence a secondary outcome.

Expert Perspectives on Leprosy Elimination

Experts in the field of leprosy elimination emphasize the need for a multi-faceted approach to address the challenges ahead. This includes increasing awareness about leprosy among clinical practitioners and the general public, reducing stigma, and improving access to medical care and other services for those affected.

Implications for Readers in India

The continued transmission of leprosy in many parts of India has significant implications for readers in the country. It is essential for individuals to be aware of the risks of leprosy and take steps to prevent transmission, such as avoiding close contact with individuals who have the disease and seeking medical care if symptoms occur.

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Way Forward for Leprosy Elimination in India

The government should resist the temptation to ease detection or revise its elimination targets and instead redouble its investments to meet the extant 2026-27 projections. It should commit its augmented efforts at locations and social settings where both late diagnosis and transmission remain trenchant.

• The government should focus on cutting transmission, in line with WHO.
• The programme should be tailored to address the specific needs of highly endemic areas.
• Efforts should be made to reduce stigma and improve awareness about leprosy among clinical practitioners and the general public.
• The government should consider using innovative approaches, such as digital surveillance and the MIP vaccine, to accelerate pathogen clearance in patients deemed highly infectious.

46% of all cases reported among children in 2025 were from India, highlighting the need for the programme to move in tandem with the WHO. The government should also prioritize the development of new diagnostics and treatments for leprosy, as well as improve access to existing medical care and other services for those affected.

What to Watch Next in Leprosy Elimination

In the coming years, it will be essential to monitor the progress of leprosy elimination efforts in India and adjust strategies as needed. This may involve increasing investments in areas with high transmission rates, improving access to medical care and other services, and reducing stigma and improving awareness about leprosy among clinical practitioners and the general public.

Timeline of Leprosy Elimination Efforts in India

Here is a brief timeline of leprosy elimination efforts in India:

• 2005: The World Health Organization (WHO) declares that India has “eliminated [leprosy] as a public health problem”.
• 2010s: Disability due to leprosy begins to rise, prompting door-to-door screening.
• 2023-2027: The National Strategic Plan (NSP) and Roadmap for Leprosy are launched to eliminate leprosy in India.
• 2025-26: Workers screen more than 70 crore people in highly endemic areas, detecting 24,367 cases, and ASHA workers flag nearly 40 lakh suspected cases, with 48,027 cases confirmed.

Conclusion

In conclusion, while India has made significant progress in reducing the prevalence of leprosy, there are still significant challenges ahead. The government needs to double down on interrupting transmission and make prevalence a secondary outcome. It is essential for individuals to be aware of the risks of leprosy and take steps to prevent transmission, such as avoiding close contact with individuals who have the disease and seeking medical care if symptoms occur.