The Central government has approved a new treatment regimen for leprosy, aiming to stop its transmission at the sub-national level by 2027, three years ahead of the UN’s Sustainable Development Goals. According to a letter written by the Directorate General of Health Services (DGHS), the National Leprosy Eradication Programme is taking all the required steps to stop the transmission of leprosy.
“Now with the approval of the competent authority, the Ministry of Health and Family Welfare has decided to introduce a three-drug regimen for Pauci-Bacillary (PB) cases in place of a two-drug regimen for six months,” the letter written by Sudarshan Mandal, Deputy Director General, DGHS, stated.
The letter, dated January 17, said that the move follows the “latest, globally accepted scientific research studies and evidence-based practices”.
It further added that the World Health Organization (WHO) had agreed to supply the revised drug regimen from April 1, 2025. Thus, all States and Union Territories have now been asked to send their requisitions for anti-leprosy drugs 12 months beforehand. The revised classification of leprosy and the treatment regimen for PB and multi-bacillary (MB) cases in India will be implemented from the same date.
According to the WHO, leprosy is a chronic infectious disease caused by the Mycobacterium leprae bacteria. The disease predominantly affects the skin and peripheral nerves. Left untreated, it may cause progressive and permanent disabilities.
The bacteria are transmitted via droplets from the nose and mouth during close and frequent contact with untreated cases. Leprosy, reported from all the six WHO regions, is curable with multi-drug therapy (MDT). The majority of new cases detected annually are from South East Asia.
The letter also states that PB patients have fewer bacteria visible and show no signs of advanced disease in biopsies, while MB patients have visible bacteria and may show signs of more advanced disease in biopsies.
“We believe that this new treatment regimen for leprosy patients will mark a significant step forward in our collective efforts to eradicate leprosy in India by 2027,” the letter said.
The WHO’s recommended treatment regimen consists of three drugs — dapsone, rifampicin and clofazimine. The combination is referred to as MDT. The duration of treatment is six months for PB and 12 months for MB cases. MDT kills the pathogen and cures the patient.
The WHO has been providing MDT free of cost. Free MDT was initially funded by the Nippon Foundation and since 2000, it has been donated via an agreement with Novartis. This regimen is known as ‘Uniform MDT’, where a single three-pack kit can be given to all leprosy patients. This measure facilitates ease of administration. Healthcare experts say it makes it easier for the manufacturers, too.
When asked about the need for the three drug regime, Kabir Sardana, Professor, Dermatology, Ram Manohar Lohia Hospital, explained that it was true there was no specific need as such for three drugs since the two drug regimen had adequate efficacy. Moreover, as relapses are low in PB MDT, three drugs are not strictly needed. The third drug — clofazamine — also causes its own side effects, the most disconcerting of which is the red colour of the skin, Dr. Sardana said.
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