Editorial: India's leprosy numbers overshoot targets, two decades after 'elimination'
India 'eliminated' leprosy in 2005. Why are thousands of children still catching it?
Published 7 October 2026. Written by Pratidin from the reports linked at the end; every fact checked by a separate review before publishing. How we work
An editorial in The Hindu, "Break the chain", argues that India is falling short of its own leprosy goals under the National Strategic Plan and Roadmap for Leprosy 2023-2027. Citing the National Leprosy Eradication Programme's (NLEP) report for 2025-26, it says overall incidence overshot projections by 41%, incidence among children by 91.6% and the grade-2 disability rate by 34%, and that only 148 of the 300 districts projected to achieve "interruption of transmission" did so. The report counts 91,783 new cases in 2025-26, of which 3,832 (4.18%) were children; WHO data put India's share of the world's newly detected child cases at nearly half.
Leprosy is caused by the bacterium Mycobacterium leprae and spreads through droplets during prolonged close contact with untreated patients. It damages the skin, peripheral nerves and eyes, and is curable with multidrug therapy (MDT). Grade-2 disability means visible deformity or damage already present when a case is found; the 2025-26 rate was 1.34 per million against a target of less than one. New cases among children signal recent transmission in the community. Active case finding matters: Leprosy Case Detection Campaigns found 24,367 cases and ASHA-led surveillance confirmed 48,027, about 52% of the year's total.
The editorial traces the problem to complacency after India achieved "elimination as a public health problem" (a prevalence below one case per 10,000 people) in 2005. Folding leprosy services into general health care thinned specialist attention, it argues, and because MDT shortened the time patients stay on the register, low prevalence figures hid continuing transmission. Stigma and late diagnosis, often by doctors unfamiliar with the disease, remain obstacles. It notes the government's move to digital surveillance and its consideration of a vaccine based on Mycobacterium indicus pranii (MIP), and post-exposure prophylaxis that reached 91.1% of 16.9 lakh contacts. Five States, Maharashtra, Chhattisgarh, Jharkhand, Odisha and Madhya Pradesh, account for nearly half of the burden.
Prelims facts
- India recorded 91,783 new leprosy cases in 2025-26, including 3,832 children (4.18%), according to NLEP data.
- The editorial says incidence overshot projections by 41%, child incidence by 91.6% and the grade-2 disability rate by 34%.
- Only 148 districts achieved interruption of transmission, against 300 projected under the National Strategic Plan 2023-2027.
- India achieved elimination as a public health problem, a prevalence below 1 per 10,000 population, in 2005; prevalence in 2025-26 was 0.56 per 10,000.
- WHO recommends a single dose of rifampicin as post-exposure prophylaxis for close contacts of leprosy patients.
Quick recall
- Which bacterium causes leprosy?
- Mycobacterium leprae.
- What does 'elimination as a public health problem' mean for leprosy?
- Prevalence below one case per 10,000 population; India reached it in 2005.
- New leprosy cases in India in 2025-26?
- 91,783, of which 3,832 (4.18%) were children.
- By how much did child incidence overshoot projections in 2025-26?
- 91.6%, according to The Hindu's editorial citing NLEP data.
- How many districts achieved interruption of transmission in 2025-26?
- 148, against 300 projected.
- Which three drugs make up leprosy MDT?
- Dapsone, rifampicin and clofazimine.
- When did the National Leprosy Control Programme become the NLEP?
- 1983, after multidrug therapy was introduced.
- What is WHO's global leprosy strategy for 2021-2030 called?
- Towards zero leprosy.
Prelims practice question
With reference to leprosy in India, consider the following statements:
1. 'Elimination as a public health problem' means a prevalence rate below one case per 10,000 population.
2. The National Leprosy Eradication Programme was earlier known as the National Leprosy Control Programme.
3. A single dose of rifampicin is given to close contacts of patients as post-exposure prophylaxis.
Which of the statements given above are correct?
- 1 and 2 only
- 2 and 3 only
- 1 and 3 only
- 1, 2 and 3
Show answer
Answer: (d) 1, 2 and 3. All three are correct. Elimination is defined as prevalence below 1 per 10,000; India reached it in 2005. The National Leprosy Control Programme of 1954-55 became the NLEP in 1983 after MDT was introduced. Single-dose rifampicin post-exposure prophylaxis is recommended by WHO and used under the NLEP.
Use this in UPSC Mains: previous-year questions
Recurring theme: Public health beyond targets: community-level detection and the unfinished fight against neglected diseases
- How to use this
Use leprosy to show that community-level detection by ASHAs and campaigns, not hospital care alone, is what breaks transmission chains.
- In 2025-26 ASHA-led surveillance confirmed 48,027 leprosy cases, about 52% of the 91,783 new cases, and campaigns found 24,367.
- Single-dose rifampicin prophylaxis for contacts reached 91.1% of 16.9 lakh contacts, a community-level preventive step.
- Child incidence still overshot projections by 91.6%, showing gaps in early community detection.
- How to use this
Show that letting a disease-specific focus fade inside primary care can reverse gains, using leprosy's missed targets.
- India eliminated leprosy as a public health problem in 2005, yet recorded 91,783 new cases in 2025-26.
- The Hindu's editorial blames complacency and the dilution of specialist attention after leprosy was folded into general health services.
Leprosy prevention through contact prophylaxis and case-finding is the kind of preventive and promotive care the statement says India's public system neglects.
Mains practice question
Two decades after India eliminated leprosy as a public health problem, new cases among children are running well above targets. Analyse the reasons and suggest measures to interrupt transmission. (250 words)
Model answer
India achieved elimination of leprosy as a public health problem (prevalence below 1 per 10,000) in 2005, but the NLEP's 2025-26 data show 91,783 new cases, 3,832 of them children, and child incidence 91.6% above projections.
Why the targets were missed
- Complacency after 2005: elimination was read as the end of the disease, and focus faded.
- Integration into general health services: specialist skills thinned; doctors unfamiliar with leprosy diagnose late.
- Prevalence hides transmission: MDT shortens time on the register, so low prevalence masked new infections.
- Long incubation: symptoms can take up to 20 years to appear, which makes surveillance hard.
- Stigma: patients hide symptoms, so disability is already present at detection; the grade-2 disability rate was 34% above projection.
- Concentration: five States account for nearly half the burden.
Measures
- Track incidence, not just prevalence: child cases and grade-2 disability are better signals of transmission.
- Active case finding: campaigns found 24,367 cases and ASHA-led surveillance confirmed 48,027 in 2025-26; extend them to high-burden districts.
- Protect contacts: single-dose rifampicin prophylaxis reached 91.1% of 16.9 lakh contacts; aim for full coverage.
- New tools: digital surveillance and a possible MIP-based vaccine.
- Fight stigma: train primary care doctors, counsel communities and repeal discriminatory laws, as the NLEP urges States.
Conclusion
Meeting the national goal of interrupting transmission by 2030 needs leprosy treated as an active epidemic in its remaining pockets, not a solved problem.
The basics
Why this matters
Leprosy shows a trap that applies to many public health goals: hitting a target is not the same as ending a disease. For GS2 you need to know what leprosy is, what India's 2005 "elimination" meant, how the programme finds and treats cases, and why the numbers from 2025-26 worry experts.
The disease
Leprosy and Mycobacterium leprae is an infection of the skin and nerves. It spreads slowly, through droplets during prolonged close contact, and can take up to 20 years to show symptoms. It is curable with multidrug therapy of dapsone, rifampicin and clofazimine taken for 6 or 12 months. Untreated, it damages nerves and leads to disability.
What 'elimination' meant
In 2005 India brought leprosy prevalence below one case per 10,000 people. That is elimination "as a public health problem", not eradication. The difference between Prevalence and incidence explains why the disease could keep spreading after that date.
- Cases on the register at a point in time
- Falls quickly when treatment is short
- Basis of the 2005 'elimination' target
- New cases detected in a period
- Shows whether transmission continues
- 2025-26: 91,783 new cases
How India fights it
The National Leprosy Eradication Programme finds cases through campaigns and ASHA workers, treats them with free MDT, and protects contacts through Post-exposure prophylaxis with single-dose rifampicin.
- 1954-55National Leprosy Control Programme launched
- 1983Renamed NLEP after multidrug therapy is introduced
- 2005Prevalence falls below 1 per 10,000: elimination as a public health problem
- 2023National Strategic Plan and Roadmap for Leprosy 2023-2027; Nikusth 2.0 portal launched
- 2025-2691,783 new cases; child incidence 91.6% above projection
Where the plan fell short
The editorial compares the 2025-26 results with the strategic plan's projections. All three key measures overshot.
The way forward
Experts quoted in coverage of the report point to poor detection. Reaching the goal of interrupting transmission by 2030 means finding cases earlier, covering every contact and fighting the stigma that keeps patients hidden.
Go deeper
In one line: India's 2025-26 leprosy data show new cases, child cases and disabilities well above plan, and The Hindu argues that complacency after 2005 is to blame.
Why it matters for UPSC
GS2 health questions ask about community-level health care and primary health structures (Mains 2018, 2021). Leprosy is a clear case of a disease that persists after a target is met, and Prelims can test definitions and programme facts.
The core idea
Leprosy and Mycobacterium leprae spreads slowly and can stay hidden for years. India met the target of prevalence below 1 per 10,000 in 2005, but the gap between Prevalence and incidence meant transmission continued. The National Leprosy Eradication Programme now relies on active case-finding and on Post-exposure prophylaxis with single-dose rifampicin for contacts.
Numbers and dates to remember
- 2025-26: 91,783 new cases; 3,832 children (4.18%).
- Prevalence 2025-26: 0.56 per 10,000.
- Overshoot against projections: incidence 41%, child incidence 91.6%, grade-2 disability rate 34%.
- 148 of 300 projected districts achieved interruption of transmission.
- Grade-2 disability rate: 1.34 per million, target below 1.
- 1954-55: National Leprosy Control Programme; 1983: NLEP.
- 2005: elimination as a public health problem.
Where to go next
- Leprosy and Mycobacterium leprae: the disease, its spread and its cure.
- Prevalence and incidence: why the 2005 target hid ongoing spread.
- National Leprosy Eradication Programme: how India finds and treats cases.
- Post-exposure prophylaxis with single-dose rifampicin: protecting contacts to break the chain.
Go deeper: elimination, complacency and stigma
The editorial's case. The Hindu argues that the 2005 milestone bred complacency. Leprosy services were merged into general health care, which reduced specialist attention, and short MDT courses meant patients left the register quickly. Prevalence, the measure behind the target, fell even while new infections continued. This is why Prevalence and incidence must be read together.
What the data say. Child cases are the clearest signal of recent spread, and India's 3,832 child cases in 2025-26 were well above plan. Grade-2 disability at detection, 2.12% of new cases, shows many patients are found late. Dr Kabir Sardana, head of dermatology at ABVIMS-Dr RML Hospital, Delhi, has said the data point to poor detection.
What is working. The National Leprosy Eradication Programme now finds a large share of cases actively: ASHA-led surveillance confirmed 48,027 cases, about 52% of the year's total, and campaigns found 24,367. Post-exposure prophylaxis with single-dose rifampicin reached 91.1% of contacts, according to the editorial. The 2025-26 report also shows 654 of 768 districts below the elimination threshold.
The hard part. Stigma keeps people from seeking care, and Leprosy and Mycobacterium leprae can incubate for years. The NLEP urges States to repeal laws that discriminate against people affected by leprosy. WHO's global strategy for 2021-2030, "Towards zero leprosy", aims at zero infection, disease, disability and stigma, a broader goal than the prevalence target India met in 2005.
Leprosy and Mycobacterium leprae
The disease, its spread and its cure.
In one line: Leprosy (Hansen disease) is a curable bacterial infection of the skin and nerves caused by Mycobacterium leprae.
How it spreads and what it does
The bacterium spreads through droplets from the nose and mouth during prolonged close contact with untreated patients. Casual contact such as shaking hands or sharing meals does not spread it. It affects the skin, peripheral nerves, the lining of the upper respiratory tract and the eyes. Symptoms may appear within a year or take up to 20 years.
Treatment
WHO recommends multidrug therapy with three medicines, dapsone, rifampicin and clofazimine, for 6 months in milder cases and 12 months in severe ones. Early diagnosis prevents disability; late diagnosis can leave permanent nerve damage, recorded as grade-2 disability.
Where to go next
Prevalence and incidence
Why the 2005 target hid ongoing spread.
In one line: Prevalence counts the cases on the register at one time; incidence counts the new cases that appear over a period.
Why the difference matters
If treatment is short, patients leave the register quickly, so prevalence falls fast even if new people keep getting infected. Incidence shows whether the disease is still spreading.
The 2005 target
India reached "elimination as a public health problem", a prevalence below one case per 10,000 people, in 2005. Prevalence was 0.56 per 10,000 in 2025-26. But new cases, 91,783 in that year, ran 41% above projections, according to The Hindu's editorial.
Better signals
New cases among children and the share of new patients with grade-2 disability are now watched closely, because they reveal recent transmission and late detection.
Where to go next
National Leprosy Eradication Programme
How India finds and treats cases.
In one line: The NLEP is India's national programme to find, treat and stop the spread of leprosy.
History
The National Leprosy Control Programme began in 1954-55. It became the National Leprosy Eradication Programme in 1983 after multidrug therapy was introduced. India achieved elimination as a public health problem in 2005.
Current strategy
The National Strategic Plan and Roadmap for Leprosy 2023-2027 aims to interrupt transmission by 2030. Tools include Leprosy Case Detection Campaigns in high-endemic areas, ASHA-based surveillance, free MDT, single-dose rifampicin for contacts, and the Nikusth 2.0 web portal launched on 30 January 2023. The programme also urges States to repeal laws that discriminate against people affected by leprosy.
In the news
The 2025-26 report shows the plan's projections were overshot on incidence, child cases and disability.
Where to go next
Post-exposure prophylaxis with single-dose rifampicin
Protecting contacts to break the chain.
In one line: Close contacts of a leprosy patient are given a single dose of the antibiotic rifampicin to reduce their chance of developing the disease.
The idea
Leprosy spreads mainly within households and close communities. Screening contacts and giving them one dose of rifampicin, a drug already used in MDT, can break the chain of transmission. WHO recommends this approach.
India's coverage
Under the NLEP, coverage of single-dose rifampicin prophylaxis rose from 71% in 2019-20 to 92% in 2024-25, according to the Health Ministry. The Hindu's editorial says it reached 91.1% of 16.9 lakh contacts in 2025-26.
Why it matters now
With child cases running above target, protecting every contact in high-burden districts is central to the 2030 goal of interrupting transmission.
Where to go next
Take the 7 October 2026 quiz: 30 Prelims-style questions with answers