India must prioritize stopping leprosy spread over low numbers

UPDATE - follow-up to Break the chain: On leprosy in India: India still faces active transmission of leprosy in many areas even though overall adult and child rates and grade-2 disability numbers have fallen over the last ten years. This ongoing spread makes it hard for the country to reach goals set in the National Strategic Plan and Roadmap for Leprosy 2023-2027.

Screening Numbers

During 2025-26, health workers checked over 70 crore people in high-risk areas and found 24,367 cases. ASHA workers also flagged nearly 40 lakh suspected cases, which led to 48,027 confirmed diagnoses. Workers gave a single dose of rifampicin as a protective medicine to 91.1% of the 16.9 lakh people likely to have been in contact with patients. Meanwhile, the government started digital tracking and is thinking about using the MIP vaccine to speed up recovery in high-risk patients.

Uneven Burden

India achieved public health elimination in 2005 when national cases dropped below 1 per 10,000 people, but officials then mixed the surveillance system into general healthcare and shortened treatment registration times. Disability began to climb in the early 2010s. The disease burden is very uneven, with Chhattisgarh, Jharkhand, Odisha, and Maharashtra carrying heavy shares of the total cases. The 2025-26 National Leprosy Elimination Programme report shows that only 148 districts have stopped transmission out of 300 expected districts.

Challenges In Care

Many patients suffer nerve damage before getting medical help because of social stigma, and many doctors misread leprosy as a basic skin issue. The 2025-26 report reveals that overall sickness rates went past projections by 41%, child rates by 91.6%, and grade-2 disability rates by 34%. Experts say the state must focus on stopping transmission, treat prevalence as secondary, and keep current 2026-27 targets without lowering standards.

Context

Leprosy is a chronic infectious disease that mainly affects the skin and peripheral nerves, and early detection and treatment are vital to prevent long-term disability. Public health campaigns rely heavily on community health workers like ASHA staff to find cases early and break chains of infection in high-risk regions.