Young child with leprosy spots on his back

Leprosy continues to be a devastating disease if not detected and treated in time. It is an infectious disease, also known as Hansen’s disease, caused by a bacterium, Mycobacterium leprae that mainly affects the skin, peripheral nerves and the eyes, which can result in long-term consequences. Leprosy has a long incubation period of three to five years on average, though in some cases incubation can take as long as 20 years. During the incubation period, an infected person does not yet have any visible signs or symptoms but may already infect others. Only when skin spots or signs of nerve damage occur, and a person finds their way to a health facility, will they be examined for leprosy.

A person affected by leprosy with senseless spots her arm due to leprosy complications
A young boy, affected by leprosy, with senseless spots on his face due to leprosy complications

Physical and communal impact

If left untreated, leprosy can cause paralysis and disfigurement of hands and feet, shortening of toes and fingers, chronic ulcers on the hands or the soles of the feet, and blindness. As the disease attacks the nerves, persons affected by leprosy do not have any sensation in the affected body parts, which can easily lead to, the worsening of, disabilities. The fact that there is an increased risk for a leprosy patient’s family and neighbours to become infected with the disease, makes leprosy a significant social and communal challenge.

Leprosy creates vicious cycle of poverty

Extremely poor people are at particularly high risk of developing leprosy. Research has shown that they are systematically excluded and derive very little benefit from development or health care interventions in general. Women experience particular disadvantages. The sufferingthat leprosy causes, and the risk of developing disabilities, puts poor patients in a vicious cycle of poverty, stigma, unemployment, social exclusion, and mental health problems.

Leprosy is one of the neglected tropical diseases specifically targeted by the World Health Organisation. In 1991, the World Health Organisation set a global target for the elimination of leprosy as a public health problem by 2000. Great strides were made during that time in detecting and treating leprosy cases with Multi-Drug Therapy which contributed to the official elimination at national level in 116 of the 122 leprosy endemic countries in 2005. However, despite these significant successes, new leprosy cases still continue to occur.

Rosemary, a person affected by leprosy, from Brazil with numb spots on her body due to leprosy complications
Numb hands due to leprosy complications
A person affected by leprosy from Brazil with numb feet due to leprosy complications gets new bandages from his wife

Millions of people are still at risk

In their 2017 leprosy update, WHO reported a total of 210,671 new leprosy patients detected worldwide with a total of 12,189 new cases of people with visible impairments. On the African continent, a total of 20,416 new leprosy cases were identified (a slight increase compared to 2016), with 2,911 new cases of people with visible impairments. The problem with these official figures is that they only reflect patients that sought medical assistance and were recorded in the national data for each country. They do not include those people that either have not yet manifested symptoms or were misdiagnosed, nor does it include the contacts of leprosy patients who run the risk of contracting the disease. Research done by Erasmus MC and NLR, shows that even by modest calculations, millions of people are still at risk.

Leprosy numb spots test with a pen
Leprosy doctor checks patient on symptoms of leprosy
Leprosy detection team uses mobile skinapp in Mozambique

Towards zero leprosy

A recent breakthrough is the introduction of prevention of leprosy by prescribing “post-exposure prophylaxis” also knows as PEP to contacts of newly-diagnosed leprosy patients. The treatment reduces the risk of contacts developing leprosy by nearly 60%. NLR strives to promote the implementation of PEP as widely as possible, believing that it will be a definitive step towards zero leprosy.

A person affected by leprosy from Brazil with numb feet due to leprosy complications gets new bandages from his wife

until No Leprosy Remains

NLR is a global forerunner towards a leprosy free world. We promote and support prevention and treatment of leprosy, prevention of disabilities, social inclusion and stigma reduction. We focus on four priority programmes.