Break the chain: On leprosy in India

India has made significant progress in reducing leprosy cases and disability rates over the past decade, yet the disease still remains a public health challenge. In 2005, the national prevalence of leprosy dropped below 1 case per 10,000 people, leading the World Health Organization (WHO) to declare India as having "eliminated leprosy as a public health problem".

However, complacency set in, leading to the dissolution of the leprosy surveillance program into the general health system and the implementation of shorter multi-drug treatment regimens, which allowed transmission to continue unabated.

In recent years, disability due to leprosy has been on the rise, prompting door-to-door screening efforts. According to the 2025-26 National Leprosy Elimination Programme report, only 148 districts have achieved 'interruption of transmission', while only 16.9 lakh likely cases were administered single-dose rifampicin as post-exposure prophylaxis. The government is also considering the use of the MIP vaccine to accelerate pathogen clearance in high-risk patients.

Despite these challenges, research has shown that many patients have already suffered nerve damage by the time they seek care, largely due to stigma and misdiagnosis. To address these issues, the state should prioritize interrupting transmission and improve care for affected individuals. The 2025-26 report reveals that overall incidence of leprosy has surpassed projections by 41%, while incidence among children has increased by 91.6% and the grade-2 disability rate by 34%.

By focusing efforts on high-risk locations and social settings, India can make significant strides in meeting its elimination targets for 2026-27.