Article 2: Break the chain
Why in news: India has reduced the prevalence and disability caused by leprosy, but continued transmission, childhood cases, delayed diagnosis and regional concentration threaten the targets of the 2023–2027 national roadmap.
Key Details
- Progress with continuing transmission: India brought prevalence below 1 case per 10,000 people by 2005, but transmission continues in several high-burden areas.
- Uneven disease burden: Chhattisgarh, Jharkhand, Odisha and Maharashtra account for a significant share of cases. Only 148 districts have achieved interruption of transmission against the target of 300.
- Large-scale detection: In 2025–26, health workers screened over 70 crore people in high-risk areas and detected 48,027 confirmed cases, while ASHA workers supported case identification.
- Children remain vulnerable: India accounted for about 46% of global child leprosy cases reported in 2025, highlighting the need for early detection and stronger contact-based prevention.
- Gaps in care: Stigma, delayed treatment and misdiagnosis often allow nerve damage to develop. Digital surveillance, preventive rifampicin and improved clinical training can help interrupt transmission.
Present Status and Transmission
- India has witnessed a decline in leprosy prevalence and Grade-2 disability over the past decade.
- In 2005, prevalence fell below 1 case per 10,000 people, leading WHO to recognise India as having eliminated leprosy as a public health problem.
- However, transmission continues in several pockets of the country.
- Only 148 districts have achieved “interruption of transmission” against the projected 300 districts.
- Chhattisgarh, Jharkhand, Odisha and Maharashtra continue to carry a disproportionate share of the disease burden.
Surveillance and Detection
- Integration of leprosy surveillance into the general health system weakened focused monitoring.
- Shorter treatment regimens also reduced the period during which patients remained formally registered, even though transmission continued.
- In 2025–26, more than 70 crore people were screened in highly endemic areas.
- Around 24,367 cases were detected through screening, while ASHA workers identified suspected cases and 48,027 cases were confirmed.
- Digital surveillance is now being strengthened to improve detection and monitoring.
Children and Prevention
- Children accounted for a significant share of new cases, indicating ongoing transmission.
- India accounted for around 46% of leprosy cases reported among children globally in 2025, according to the article.
- Around 91.1% of 16.9 lakh eligible contacts received single-dose rifampicin post-exposure prophylaxis.
- Early detection and contact tracing are important to break chains of transmission.
- The National Strategic Plan (NSP) 2023–2027 appropriately focuses on interrupting transmission, consistent with WHO priorities.
Gaps in Care and Diagnosis
- Stigma often causes patients to delay seeking treatment.
- Many patients develop nerve damage by the time they receive care.
- Some healthcare practitioners may be unfamiliar with leprosy and mistake it for other skin conditions.
- Delayed diagnosis increases the risk of disability and continued transmission.
- Improving awareness among communities and healthcare workers is therefore essential.
Way Forward
- The focus should shift from merely reducing prevalence to interrupting transmission.
- India should maintain its existing elimination targets rather than lowering them because of shortfalls.
- The 2025–26 report recorded incidence 41% above projections, child incidence 91.6% above projections and Grade-2 disability 34% above projections.
- Resources should be concentrated in areas and social groups experiencing late diagnosis and persistent transmission.
- Stronger surveillance, contact tracing, early diagnosis, stigma reduction and rehabilitation are necessary to achieve the 2026–27 goals.
Conclusion
India’s leprosy strategy should focus primarily on stopping transmission rather than only reducing reported prevalence. Early detection, contact tracing, preventive treatment and community awareness must receive sustained attention. Special focus is needed on children and high-burden districts, alongside better training of healthcare workers. Reducing stigma and ensuring timely treatment will be essential for achieving India’s leprosy elimination targets.