Today, on World Leprosy Day, WHO is highlighting the urgent need for countries in the South-East Asia Region and globally to act now to accelerate towards zero leprosy infection and disease, zero leprosy disability, and zero leprosy stigma and discrimination – the vision of the WHO Global Leprosy Strategy 2021–2030.
In 2021, 143 countries globally reported on leprosy. Ninety-five per cent of new cases were from 23 global priority countries. More than 140 000 new cases were reported, of which 6% were diagnosed with visible deformities or grade-2 disabilities (G2D). Over 6% of new cases were children below 15 years of age, of which 368 were diagnosed with G2D.
Despite a 10% increase in the reporting of new cases in 2021 compared with 2020, reported cases in 2021 were 30% lower than in 2019. This is not because transmission has reduced, but because cases have been missed due to COVID-19-related disruptions.
Countries must continue to urgently restore leprosy services, with a focus on expanding single dose rifampicin chemoprophylaxis, intensifying active case finding, and ensuring prompt diagnosis and treatment with multidrug therapy.
Specific attention should be given to vulnerable populations, including women, children, immigrants, refugees, the elderly, the homeless, residents of deprived leprosy ‘colonies’ and those living in geographically inaccessible areas.
Over the last decade, the world has achieved strong progress in several key areas of leprosy prevention, treatment and control. Between 2010 and 2019, new child case detection was reduced by 27%. Between 2014 and 2019, visible deformities at the time of diagnosis were reduced by 23%, and by 2019, the new child case detection rate was 7.6 per million children as opposed to 9.8 in 2014.
However, today, in addition to COVID-19-related challenges, stigma and discrimination – both institutionalized and informal – continue to impede prompt diagnosis and treatment, and to facilitate onward spread. In 2021, at least 115 discriminatory laws were reported to be in place in seven countries. A total 124 instances of discrimination were reported.
WHO calls on all leprosy-affected countries to immediately and unequivocally revoke discriminatory laws, and to fully comply with and implement the UN principles and guidelines for the elimination of discrimination against persons affected by leprosy and their families.
Countries should also increase access for persons affected by leprosy and their families to mental health care, a key feature of the Global Leprosy Strategy. Up to 50% of persons affected by leprosy face psychiatric morbidities such as depression, anxiety disorders and suicide attempts. In 2020, a reported 86% of health facilities in leprosy-affected countries had trained counsellors available at the time of diagnosis and for follow-up treatment, which must be further scaled.
Crucially, persons affected by leprosy must be engaged, empowered and involved in all aspects of decision-making, including in service design and delivery, and in social and economic activities. For this, community-based organizations and networks should be supported, nurtured and included in decision-making processes. Community-based services that strengthen livelihoods and optimize inclusion should be expanded, and access to social entitlements and other welfare measures ensured.
To address dwindling skills and expertise in leprosy, WHO has developed a series of online training courses and e-learning modules, which countries must continue to access to improve front-line capacity as they move towards the zero leprosy targets.
Together, we must interrupt transmission and eliminate this millennia-old disease. On World Leprosy Day, WHO reiterates its steadfast support to leprosy-affected countries in the South-East Asia Region and across the world to drive rapid, equitable and sustained progress towards our targets and goals, achieving zero leprosy infection and disease, zero leprosy disability, and zero leprosy stigma and discrimination by 2030, leaving no one behind.