India’s Landmark Progress Against Leprosy
India is reporting a remarkable public health success: a 99% reduction in the prevalence of leprosy (Hansen’s disease) per 10,000 population over the last 44 years. The government says the country’s prevalence has fallen from 57.2 per 10,000 in 1981 to 0.57 per 10,000 in 2025, alongside a 98% drop in cases under treatment. This sustained progress underlines the impact of policy, programmatic rigor, and community engagement in tackling a historically stigmatized disease.
What Changed: From Crisis to Control
Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Symptoms can include discolored skin patches, loss of sensation, muscle weakness, and potential deformities if untreated. Transmission occurs mainly through prolonged close contact with untreated individuals. A turning point arrived with the introduction of Multidrug Therapy (MDT) in 1983, combining rifampicin, dapsone, and clofazimine. MDT transformed leprosy into a curable condition and laid the foundation for national control efforts.
A National Leprosy Eradication Programme (NLEP) that Worked
The National Leprosy Eradication Programme (NLEP) — a Centrally Sponsored Scheme under the National Health Mission (NHM) — prioritized early diagnosis, free treatment, and prevention of disabilities. The government notes that sustained MDT supply, timely adoption of global guidance, and ongoing innovations were crucial to reducing transmission and disabilities. The program’s success culminated in the country achieving elimination as a public health problem in March 2005, defined as a prevalence rate below 1 per 10,000 population nationwide.
Current Status and Sub-National Progress
As of 2025, India’s national prevalence stands at 0.57 per 10,000, with 0.82 million patients on treatment. The 1981 baseline was 57.2 per 10,000, with 39.19 lakh patients on treatment. Since March 2006, when the annual report confirmed a prevalence rate of less than 1 per 10,000 (0.84), there has been a 37% decline in new case detection, reflecting a continued focus on early detection and interrupting transmission.
Remarkably, the NLEP has not rested on past laurels. By March 2025, 31 states and 638 districts had achieved a prevalence rate below 1 per 10,000. This dispersion of success across states and districts demonstrates that elimination is feasible across diverse settings in the country, not just in isolated regions.
Strategic Elements Driving Success
Key elements in India’s leprosy control strategy include:
- Free, readily accessible MDT treatment nationwide, ensuring no patient is turned away due to cost.
- Post-exposure prophylaxis and intensified case-finding to prevent disability and transmission.
- Integration of leprosy screening with broader health schemes such as Ayushman Bharat and child health programs (RBSK and RKSK), expanding reach to both adults and children.
- Alignment with global guidance and the WHO Roadmap for Neglected Tropical Diseases 2021-2030, aiming for interruption of transmission by 2030.
- Strong political will, sustained funding, and active community engagement to reduce stigma and encourage early treatment-seeking behavior.
What to Expect Moving Forward
With India approaching its zero-transmission goal, continued commitment remains essential. The government emphasizes that achieving and sustaining elimination at the sub-national level requires ongoing surveillance, timely updates to treatment regimens, and robust public participation. While the journey toward zero transmission is ambitious, the current trajectory shows that decisive policy action paired with community involvement can dramatically reduce a once-pervasive disease’s burden.
Conclusion
The 99% decline in leprosy prevalence over four decades stands as a testament to India’s public health capabilities, governance, and patient-centered care. As the nation marches toward its 2030 target, the collaboration among government programs, health workers, communities, and international guidance provides a blueprint for eradicating neglected diseases through sustained effort and inclusive health strategies.
