Towards Zero Transmission
Our efforts to interrupt the transmission of leprosy have seen great strides since 2019. We have seen progress in our active case finding efforts and in early detection. The steady number of new cases diagnosed annually through TLM support is evidence of this.
We have also seen that leprosy control initiatives have been energised and strengthened through implementation of PEP – with screening of contacts and communities increasing through close partnership with community mobilisers.
One of the reasons that we have seen progress towards interrupting leprosy transmission is because health workers at the community level have been trained and supervised in their efforts to detect leprosy early and treat it.
Active case finding means health workers visiting communities to search for new cases. It is time and cost intensive, but it is the most effective way to interrupt leprosy transmission.
Our staff in every country tell us that community mobilisation and participation in leprosy work has been a vital contributor to the success and sustainability of leprosy control initiatives led by National Leprosy Programmes.
A key example is the successful community mobilisation and advocacy leading to improved leprosy surveillance in Kunignan District, Indonesia >>
The Leprosy Friendly Village (LFV) model supports the Indonesian leprosy control programme by reducing leprosy discrimination in villages and informal settlements in urban areas, which have spring up due to mass migration in search of work. Through community mobilisation - increasing awareness and support for people affected by leprosy - it increases uptake of case finding activities like mass screenings and encourages people to seek a leprosy diagnosis earlier as their fear of stigma and discrimination reduces.
Johan shares his experience of living with leprosy at a workshop for village officials and the public health department.
When we launched this strategy, we committed to utilise our research skills to develop, investigate, and trial new innovations to understand transmission and diagnosis better. We also committed to invest in succession planning and training to preserve leprosy expertise. Here are three victories from this work.
TLM’s team in India have developed a multiplex PCR (mPCR) based TrueNat test which is 100 percent accurate with MB leprosy and 88 percent accurate with PB leprosy. The test can be used in communities and is completed within an hour using nasal swabs or slit skin samples. This is a dramatic improvement on current testing, which requires laboratory testing by leprosy experts. This test could transform leprosy diagnosis across the world. Read more about this innovation here >
Dr Itu Singh and the mPCR machine.
2. A new leprosy treatment that is faster and more effective
In 2024, TLM invested $50k into the ILEP funding pot for pre-clinical trials of Telacebec for the prevention and treatment of leprosy. The pre-clinical trials are precursors of the larger clinical trials for which a large cross-agency consortium has submitted a large EDCPT grant application. The researchers leading on these trails hope that this new treatment for leprosy could allow us to dramatically cut the transmission of leprosy across the world. This is because Telacebec acts like ‘putting a glass over a flame’, cutting off the leprosy bacteria’s access to energy. A novel Telacebec-based MDT treatment regimen would be safer, shorter, and consist of fewer drugs with the possibility of eliminating the need for daily dosing. Read more about this innovation here >
In Myanmar, a volunteer from Hpa Do Disability Resource Centre provides ulcer care.
3. Closing the gap in leprosy expertise
Leprosy expertise is declining across the world, with fewer healthcare professionals able to recognise the symptoms and support patients with ongoing care. The Leprosy Mission has been contributing to ILEP’s Life Leprosy Learning Project to develop an e-learning repository. As well as this, TLM has set up a Leprosy Learning Working Group to support the continuation and development of leprosy expertise within The Leprosy Mission. Read more about this innovation here >
Over the course of this strategy, we have seen how community mobilisation has been a vital contributor to the success and sustainability of leprosy control initiatives. When Organisations of Persons Affected by Leprosy are engaged in the process, mass screenings are more likely to happen and to be successful. When people hear from persons affected by leprosy themselves about the importance of an early diagnosis, members of the community are more likely to come forward when otherwise they may have feared facing stigma.
It is also easy for government and NGO case finding efforts in a community to lose either momentum or funding. With the engagement of Organisations of Persons Affected by Leprosy in those communities, it is more likely that attention on these communities will be sustained and health-seeking behaviours of community members will be maintained so that transmission can be interrupted.
Working with Organisations of Persons Affected by Leprosy on this will be a key part of our 2025-2030 Global Strategy.
