Leprosy - still a public health threat (Accelerating the elimination of leprosy).

Towards a new strategy.

Thanks to MDT and the efforts of the WHO and the anti-leprosy community, the number of new leprosy patients detected has reduc

ed dramatically over the past 30 years. But in recent years, the anti-leprosy work has become a victim of its own success: with patient numbers falling sharply, efforts to go the last mile in eliminating the disease have stagnated. Since 2005, both the prevalence and incidence of the disease have plateaued. Today, with around 215,000 people worldwide diagnosed with leprosy every year, a more robust approach is needed to successfully go the last mile and bring leprosy transmission to zero.

To define a new strategy to interrupt transmission, the Novartis Foundation convened NTD elimination and control experts in 2013. The group reached a consensus that in addition to the cornerstone of early diagnosis and prompt treatment with MDT for all leprosy patients, a successful elimination strategy also requires tracing and preventative therapy for contacts of new leprosy patients, improvements in diagnostic tools, and strengthened epidemiological surveillance systems that are action-oriented.

Contact tracing is at the heart of another pilot project supported by the Novartis Foundation in Cambodia, in collaboration with the Cambodian National Leprosy Elimination Program and the CIOMAL Foundation. The pilot project aims at determining the yield of early case detection when contact persons of formerly diagnosed leprosy patients are screened.