With a renewed focus to tackle the scourge, the Union Health Ministry has devised a strategic road map for achieving zero cases of leprosy by 2030.
Despite India being declared “Leprosy Eliminated” in 2005, the country still accounts for over half (52%) of world’s new leprosy patients, said Union Health Minister Mansukh Mandaviya in a written message of the National Strategic Plan and Roadmap for Leprosy 2023-2027. Leprosy is a chronic bacterial infection which affects skin, nerves, lungs and eyes.
Health officials have noted that earlier gains made in the leprosy programme were reversed during COVID-19 as a sudden decline in case detection numbers was noted. Early detection of the infection in the affected person can save them from physical disability.
With COVID pandemic that occurred in 2020, case detection dropped by 43% in 2020-21 and by 34% in 2021-22 in comparison to pre-COVID year 2019-20. “Annual case detection rate has halved from 8.13 cases per lakh population to 4.56 cases in 2020-21. In 2021-22, it has settled at 5.52 cases per lakh,” the plan document notes.
Grade 2 disabilities
The Ministry has noted that decline in detection has led to increase in patients with grade 2 disabilities. COVID-19 in India had its severe impact on leprosy case detection services, and resulted in hidden cases and a probable increase in grade 2 disabilities, which may delay attainment of the goal of zero leprosy, it has stated.
In 2021-22, a total of 75,394 new cases were detected in India. A total of 1,863 grade 2 disabilities detected amongst the new leprosy cases during 2021-22, indicating the G2D rate of 1.36 per million population and 2.47% G2D among new cases. In 2022-23, for data available till August 2022, this rate has gone a notch up to 1.71 per million population.
“The agenda of eliminating leprosy at a sub-national level is still unfinished, there are a few States/Union Territories which have yet to achieve the elimination of leprosy as a public health problem,” said Roli Singh, Additional Secretary, Ministry of Health and Family Welfare (MoHFW) and Managing Director, National Health Mission.
Arunachal Pradesh, West Bengal, Bihar, Jharkhand, Odisha, Chhattisgarh, Maharashtra, Uttar Pradesh, Delhi, Madhya Pradesh, Gujarat, Dadra Nagar Haveli and Daman Diu have either one or more districts (total 82 districts) which are yet to achieve leprosy elimination target and contributes to more than 90% cases in the country.
“Chhattisgarh and Dadra & Nagar Haveli continue to report cases of leprosy more than 1 per 10,000 population despite continuous reduction in prevalence,” said Rajiv Manjhi, Joint Secretary, MoHFW.
Strong surveillance system
The Strategy focuses on achieving zero indigenous cases by accelerating case detection activities in high endemic districts and sustaining a strong surveillance system in low endemic districts.
Strategies to be adopted include acceleration of new case detection by targeted approach, stronger surveillance systems, digitalisation, introduction of advanced tools and techniques for early diagnosis and providing the most effective chemoprophylaxis to all contacts of cases. It also includes introducing a potential safe and effective vaccine, introduction of surveillance of anti-microbial resistance and adverse drug reactions, post treatment surveillance of treated cases and provide them care after cure, sustaining leprosy expertise and move towards multi-disease service integration, improved treatment outcomes by introduction of new treatment regimes and widespread awareness with impactful behavioural change communication methods.
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