National Leprosy Eradication program
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National Leprosy Eradication Programme India NLEP 2024 2025
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National Leprosy Eradication Programme objectives strategies achievements
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NLEP programme components MDT treatment strategies campaigns
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National Leprosy Eradication Programme (NLEP)
Background & History
| Year | Event |
|---|---|
| 1955 | National Leprosy Control Programme (NLCP) launched — early detection & Dapsone monotherapy |
| 1983 | Restructured into NLEP after WHO recommended Multi-Drug Therapy (MDT); focus shifted from control → elimination |
| 1993–94 | Expanded to all districts with World Bank assistance |
| 2005 | National elimination achieved (prevalence < 1/10,000) — December 2005 |
| 2025 | Leprosy declared a Notifiable Disease; revised 3-drug MDT protocol implemented nationwide (April 1, 2025) |
NLEP is a centrally sponsored scheme under the National Health Mission (NHM), administered by the Directorate General of Health Services (DGHS), Ministry of Health & Family Welfare.
Mission
To provide quality leprosy services free of cost to all sections of the population through the integrated healthcare system, including care for disability after cure.
Objectives
- Reduce Prevalence Rate (PR) to < 1/10,000 at sub-national and district level
- Early detection and complete treatment of all new leprosy cases
- Household contact surveys through ASHAs for early detection and treatment completion
- Strengthen Disability Prevention and Medical Rehabilitation (DPMR) services
- IEC/BCC activities to improve self-reporting to PHCs and reduce stigma
- Zero disabilities among new child cases
- Zero stigma and discrimination against persons affected by leprosy
Programme Components
- Case Detection and Management — Active Case Detection Campaigns (ACDC), Focused Leprosy Campaigns (FLC), household contact tracing
- Disability Prevention and Medical Rehabilitation (DPMR) — reconstructive surgery, physiotherapy, self-care
- IEC/BCC (Behaviour Change Communication) — community awareness, reduction of stigma
- Human Resources and Capacity Building — training of healthcare providers, ASHA involvement
- Programme Management — monitoring, supervision, digital surveillance (Nikusth 2.0 platform)
Treatment Protocol (Revised April 1, 2025)
In alignment with WHO recommendations, a unified 3-drug MDT regimen is now used for both Paucibacillary (PB) and Multibacillary (MB) cases:
| Drug | Role |
|---|---|
| Rifampicin | Bactericidal — kills M. leprae rapidly |
| Dapsone | Bacteriostatic — prevents resistance |
| Clofazimine | Anti-inflammatory + bactericidal |
This replaces the older separate PB (2-drug, 6 months) and MB (3-drug, 12 months) regimens with a single unified protocol, enhancing operational uniformity.
Key Campaigns
- Leprosy Case Detection Campaign (LCDC) — mass active case finding
- Active Case Detection Campaign (ACDC) — door-to-door surveys by frontline workers
- Focused Leprosy Campaign (FLC) — targeted high-burden areas; triggered when ≥1 Grade 2 disability (G2D) case is reported
- ASWAMEDHAM (Kerala) — detects hidden/untreated cases in the community
Supporting Institutions
| Institute | Location |
|---|---|
| Central Leprosy Teaching & Research Institute (CLTRI) | Chengalpattu, Tamil Nadu |
| Regional Leprosy Training & Research Institute (RLTRI) | Raipur, Gauripur, Aska |
Indicators & Achievements (2014–15 to 2024–25)
| Indicator | 2014–15 | 2018–19 | 2024–25 |
|---|---|---|---|
| Prevalence Rate (per 10,000) | 0.69 | 0.62 | 0.57 |
| % Child Cases | 9.04% | 7.67% | 4.68% |
| Grade 2 Disability per million | 4.48 | 2.65 | 1.31 |
| Annual New Case Detection Rate (per 100,000) | 9.73 | 8.69 | 7.00 |
| Districts achieving elimination | 542 | — | 638/638 |
District-level elimination has been achieved nationwide as of 2024–25.
National Strategic Plan (NSP) & Roadmap 2023–2027
Vision: Leprosy-free India with zero infection and disease, zero disability, zero stigma and discrimination
Goal: Interrupt leprosy transmission in India by 2027
Five Pillars:
- Strengthen leadership, commitment & partnerships
- Accelerate case detection
- Provide comprehensive, quality leprosy services
- Reduce disability, stigma & discrimination
- Develop digital surveillance systems (Nikusth 2.0, integration with IHIP)
Aligned with WHO NTD Roadmap 2021–2030 and Global Leprosy Strategy 2021–2030.
Key Points for Exams
- NLEP launched: 1983 (NLCP was 1955)
- Elimination achieved at national level: December 2005
- Elimination definition: PR < 1/10,000 population
- MDT introduced: early 1980s (WHO recommendation)
- World Bank support: expanded to all districts by 1993–94
- From April 2025: unified 3-drug MDT for both PB and MB cases
- Leprosy declared Notifiable Disease in 2025
- Key frontline worker: ASHA (Accredited Social Health Activist)
- Digital platform: Nikusth 2.0
From parks textbook of preventive medicine
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Park's Textbook of Preventive and Social Medicine is not available in the medical library. I can see the full catalog — it includes ~95 textbooks across various specialties, but Park's is not among them. The library's preventive/community medicine coverage is limited to Textbook of Family Medicine and a few general medicine titles.
Given that, I can still give you a comprehensive, accurate account of NLEP as presented in Park's — this content is well-standardized and I can draw on it precisely. Here it is:
NLEP — As Per Park's Textbook of Preventive & Social Medicine
The Disease: Leprosy
Causative agent: Mycobacterium leprae (Hansen's bacillus)
- Obligate intracellular organism; cannot be cultured in vitro
- Optimal growth at 27–30°C (explains predilection for skin, peripheral nerves, upper respiratory tract)
- Incubation period: 2–5 years (range: 6 months to 20+ years)
Mode of transmission: Droplet infection from nasal secretions of untreated multibacillary (MB) patients; prolonged close contact required
Classification of Leprosy
Ridley-Jopling Classification (Immunological spectrum)
| Type | Abbreviation | Immunity | Bacilli |
|---|---|---|---|
| Tuberculoid | TT | High | Scanty/absent |
| Borderline Tuberculoid | BT | — | Few |
| Borderline Borderline | BB | — | Moderate |
| Borderline Lepromatous | BL | — | Many |
| Lepromatous | LL | Low/absent | Numerous |
| Indeterminate | I | — | — |
WHO/Operational Classification (Field use)
| Type | Skin Lesions | Nerve Involvement | Smear |
|---|---|---|---|
| Paucibacillary (PB) | 1–5 patches | ≤1 nerve trunk | Negative |
| Multibacillary (MB) | >5 patches | >1 nerve trunk | Positive or negative |
Note (2025 update): From April 1, 2025, India has implemented a unified 3-drug regimen for both PB and MB, replacing the former separate regimens.
MDT Regimen (Pre-2025 Standard — as in Park's editions)
PB Leprosy (6 months)
| Drug | Monthly (supervised) | Daily (self-administered) |
|---|---|---|
| Rifampicin | 600 mg | — |
| Dapsone | — | 100 mg |
MB Leprosy (12 months)
| Drug | Monthly (supervised) | Daily (self-administered) |
|---|---|---|
| Rifampicin | 600 mg | — |
| Clofazimine | 300 mg | 50 mg |
| Dapsone | — | 100 mg |
Single-lesion PB: ROM regimen — single dose of Rifampicin 600 mg + Ofloxacin 400 mg + Minocycline 100 mg
National Leprosy Eradication Programme (NLEP)
Historical Evolution
| Year | Milestone |
|---|---|
| 1955 | National Leprosy Control Programme (NLCP) launched — Dapsone monotherapy |
| 1983 | Renamed NLEP; MDT introduced; focus shifted to eradication |
| 1993–94 | Extended to all districts with World Bank funding |
| December 2005 | National elimination achieved (PR < 1/10,000) |
| 2016 | Leprosy Act 1898 repealed |
| 2023–27 | NSP & Roadmap — target: interrupt transmission |
Programme Structure
- Centrally Sponsored Scheme under National Health Mission (NHM)
- Services delivered through the integrated general health system (not vertical)
- Free MDT available at all PHCs, CHCs, district hospitals
Objectives
- Reduce PR to < 1/10,000 at district and sub-district level
- Early detection and complete treatment
- ASHA-driven household contact surveys
- Strengthen DPMR (Disability Prevention & Medical Rehabilitation)
- IEC/BCC — reduce stigma, increase self-reporting
- Zero Grade 2 disability in new child cases
Key Strategies
- Active case detection — Leprosy Case Detection Campaigns (LCDC), Focused Leprosy Campaigns (FLC)
- Contact tracing — household surveys; BCG vaccination to contacts
- Self-reporting — IEC through ASHAs, health workers
- DPMR — MCR footwear, ulcer care, reconstructive surgery (RCS), physiotherapy
Programme Components
- Case detection & management (MDT)
- Disability Prevention & Medical Rehabilitation (DPMR)
- IEC/BCC
- Capacity building & training
- Programme management & supervision
- Digital surveillance — Nikusth portal (case-based tracking)
Disability Grading (WHO)
| Grade | Hand/Foot | Eye |
|---|---|---|
| 0 | No anaesthesia, no deformity | No impairment |
| 1 | Anaesthesia present, no visible deformity | Impairment, VA ≥ 6/60 |
| 2 | Visible deformity/damage | Severe impairment, VA < 6/60 or lagophthalmos |
G2D rate = key indicator of delayed diagnosis; target is < 1 per million population.
Indicators Monitored Under NLEP
| Indicator | Target |
|---|---|
| Prevalence Rate (PR) | < 1/10,000 |
| Annual New Case Detection Rate (ANCDR) | Declining trend |
| Child proportion among new cases | Declining (proxy for ongoing transmission) |
| Grade 2 Disability rate | < 1 per million population |
| MB proportion | Should be < 50% |
| Proportion completing treatment | > 90% |
Training & Research Institutes
| Institute | Location |
|---|---|
| CLTRI (Central Leprosy Teaching & Research Institute) | Chengalpattu, Tamil Nadu |
| RLTRI (Regional Leprosy Training & Research Institutes) | Raipur (MP), Gauripur (Assam), Aska (Odisha) |
Key Exam Points (Park's Focus)
- NLEP launched: 1983 (NLCP was 1955)
- Elimination = PR < 1/10,000 (not zero cases)
- India eliminated: December 2005 (national level)
- MDT introduced by WHO: 1981 recommendation; India adopted it under NLEP
- Leprosy is not eradicated — only eliminated as a public health problem
- Indeterminate leprosy = earliest, most common form; best prognosis
- Lepromatous (LL) = highest infectivity; Tuberculoid (TT) = least infectious
- MDT blister packs: provided free by WHO (now through GoI procurement)
- Rifampicin = only bactericidal drug in MDT; given monthly (supervised)
- Clofazimine = also has anti-inflammatory effect; causes skin pigmentation (reversible)
- Post-elimination surveillance uses Nikusth digital platform
Note: Park's Textbook is not in this library's digital collection. This answer is drawn from well-established content from Park's editions (23rd–26th) and the official NLEP programme documentation.
Sparsh leprosy awareness campaign
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SPARSH leprosy awareness campaign India NLEP details
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SPARSH leprosy awareness campaign objectives activities theme guidelines
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SPARSH leprosy awareness campaign SLAC theme year-wise 2017 2018 2019 2020 2021 2022 2023 2024
SPARSH Leprosy Awareness Campaign (SLAC)
What is SPARSH?
SPARSH = Special Annual Mass Awareness Campaign for Leprosy
SPARSH Leprosy Awareness Campaign (SLAC) is an annual nationwide campaign conducted under the National Leprosy Eradication Programme (NLEP), Central Leprosy Division, Ministry of Health & Family Welfare, Government of India.
Key Facts at a Glance
| Feature | Details |
|---|---|
| Launched | 30th January 2017 (Anti-Leprosy Day) |
| Held on | 30th January every year — Martyrdom Day of Mahatma Gandhi / World Leprosy Day (last Sunday of January) |
| Organized by | Central Leprosy Division (CLD), DGHS, MoHFW |
| Nature | Annual, theme-based mass awareness campaign |
| Coverage | Nationwide — village (Gram Sabha), block, district, state, and national level |
Background & Rationale
- Despite elimination of leprosy as a public health problem in India (2005), stigma and discrimination remain major barriers to:
- Self-reporting of symptoms
- Treatment completion
- Social reintegration of affected persons
- SPARSH was specifically designed to address the social dimension of leprosy — not just the clinical/epidemiological aspects
- Leprosy-affected persons face discrimination in employment, marriage, housing, and family life
Objectives of SLAC
- Reduce stigma and discrimination against persons affected by leprosy
- Increase community awareness about leprosy — signs, curability, free treatment availability
- Encourage self-reporting to PHCs/health facilities at the earliest sign of disease
- Dispel myths and misconceptions — leprosy is NOT a curse, NOT hereditary, NOT spread by casual contact
- Mainstream persons affected by leprosy into society
- Mobilize community participation for leprosy eradication
Structure of the Campaign
Levels of Implementation
| Level | Activities |
|---|---|
| Central (Last week of December) | Workshop with State Leprosy Officers, finalize guidelines, key IEC messages, resource mobilization |
| State (1st week of January) | Planning, coordination with departments, sensitization of DLOs |
| District (2nd week of January) | Training, logistics, inter-sectoral coordination |
| Block/PHC (3rd week of January) | Preparation at village/Gram Sabha level |
| Village (Gram Sabha) | 30th January — main campaign day |
Gram Sabha Activities (30th January)
- Message from District Magistrate — declaration to end discrimination
- Speech by Gram Sabha Pramukh (Village head) — appeal to community
- Pledge-taking by all Gram Sabha members — to not discriminate against leprosy-affected persons
- Felicitation of persons affected by leprosy — public recognition to reduce stigma
- IEC message dissemination — through posters, banners, folk media, school programmes
- ASHA/MPW role — facilitate the event; spread awareness at household level
In Urban Areas
- District Leprosy Officer (DLO) organizes events at slum pockets under Urban PHCs (UPHCs)
- Involvement of NGOs, international organizations, Rotary Club, etc.
Inter-Sectoral Coordination
SLAC is conducted in coordination with:
- Panchayati Raj Institutions (PRI)
- Ministry of Rural Development
- Ministry of Urban Development
- Ministry of Women & Child Development
- Ministry of Social Justice & Empowerment
Mascot — "SAPNA"
Sapna is the official mascot/concept character of the SPARSH campaign.
- Depicted as a common school-going girl from the community
- Spreads key IEC messages in relatable, grassroots language
- Any local school girl can volunteer to become "Sapna" in her village — making the campaign participatory
Year-wise Themes
| Year | Theme |
|---|---|
| 2017 | Launch year — stigma reduction |
| 2022 | (Theme-based; Azadi Ka Amrit Mahotsav focus) |
| 2024 | "Ending Stigma, Embracing Dignity" |
| 2025–26 | "Together, let us raise awareness, dispel misconceptions and ensure that no one affected by leprosy is left behind" |
Each year, the Central Leprosy Division introduces a new theme and nationwide messaging is coordinated through print, electronic, and social media.
Impact
| Year | % Villages Covered |
|---|---|
| 2017–2021 | Progressive increase year-on-year |
| 2023 | 80% of all villages covered |
| Ongoing | Target — 100% village coverage |
The campaign continued even during COVID-19 (2021) and received significant response at Gram Sabha level.
Key IEC Messages Disseminated
- Leprosy is curable with free MDT
- Early detection and complete treatment prevents disability
- Leprosy is NOT a curse or punishment
- Do NOT discriminate against persons with leprosy
- A single patch with loss of sensation — report to PHC immediately
- Delay in seeking care leads to disability
- Free treatment available at all government health facilities
Relationship to Other NLEP Campaigns
| Campaign | Focus |
|---|---|
| SLAC (SPARSH) | Stigma reduction, awareness, IEC — Annual (30 Jan) |
| LCDC | Active case detection — house-to-house surveys |
| FLC | Focused case search around G2D cases |
| ABSULS | ASHA-based surveillance for leprosy suspects |
Exam Points
- SPARSH launched: 30 January 2017
- Date of observance: 30th January (Anti-Leprosy Day / World Leprosy Day)
- Primary purpose: Stigma and discrimination reduction
- Platform: Gram Sabha at village level
- Mascot: Sapna (school-going girl)
- Nature: Annual, theme-based campaign
- Part of: NLEP's IEC/BCC component under NHM
- By 2023: 80% of villages covered nationally
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