National Leprosy Eradication Programme
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Direct answer
India's National Leprosy Eradication Programme began as the National Leprosy Control Programme in 1955 and was redesignated the NLEP in 1983 with multidrug therapy; the country achieved elimination as a public health problem — prevalence below 1 per 10,000 — in December 2005, yet still reports the world's largest number of new cases each year. The current focus is early detection through ASHA-led and campaign-based searches, Grade 2 disability prevention, contact interventions including single-dose rifampicin post-exposure prophylaxis, and interruption of transmission towards zero leprosy by 2030.
What you must remember
- Timeline: National Leprosy Control Programme 1955; NLEP with multidrug therapy 1983; national elimination as a public health problem in December 2005 (prevalence below 1 per 10,000).
- Case detection: incentivised ASHA-based house-to-house searches; Leprosy Case Detection Campaigns in high-endemic districts; contact examination of every new case; the Sparsh Leprosy Awareness Campaign runs around 30 January, Anti-Leprosy Day.
- Diagnosis is clinical — a hypopigmented patch with loss of sensation and thickened peripheral nerves; slit-skin smears support classification: paucibacillary (up to five lesions, smear-negative) versus multibacillary (more than five or smear-positive).
- Multidrug therapy is free in blister packs: paucibacillary — rifampicin plus dapsone for 6 months; multibacillary — rifampicin, clofazimine and dapsone for 12 months, with monthly supervised rifampicin and clofazimine and daily self-administered drugs.
- Rifampicin is the key bactericidal drug, clofazimine is bactericidal and anti-inflammatory (useful in type 2 reactions), dapsone is bacteriostatic and may cause haemolysis.
- Reactions are emergencies: type 1 (reversal) threatens nerve function and is treated with corticosteroids; erythema nodosum leprosum is treated with steroids, clofazimine or thalidomide.
- Disability focus: self-care, footwear, physiotherapy, reconstructive surgery, and Grade 2 (visible) disability in new cases as the key indicator, tracked on the Nikusth portal; single-dose rifampicin PEP goes to eligible contacts.
Common confusion
Control, elimination and eradication are the definitions most often confused: control reduces disease to an acceptable level, elimination reduces prevalence below 1 per 10,000 or interrupts transmission as a public health problem (India's 2005 achievement), and eradication means zero cases worldwide — achieved so far only for smallpox. The programme's own name says "eradication" while its achievement is elimination, a favourite viva point. Students also mix up the WHO threshold with case-detection rates, and Nikusth (leprosy) with Nikshay (tuberculosis).
Exam-focused takeaway
Questions test the years 1955, 1983 and December 2005; MDT combinations and durations; Grade 2 disability; the campaigns and ASHA incentives; and reaction management. Clinical crossovers pair a hypoaesthetic patch with classification and the correct MDT pack. Expect matching items on Nikusth versus Nikshay and on elimination versus eradication. Vivas ask for the strategy beyond elimination.
Frequently asked questions
When did India achieve leprosy elimination, and what does that mean?
December 2005, when the prevalence rate fell below 1 per 10,000 — elimination as a public health problem, not eradication; new cases still occur.
What is the MDT regimen for multibacillary leprosy?
Rifampicin, clofazimine and dapsone for 12 months, rifampicin and clofazimine monthly supervised, the rest daily self-administered; paucibacillary disease gets rifampicin and dapsone for 6 months.
What is the Sparsh Leprosy Awareness Campaign?
A nationwide annual campaign around 30 January, Anti-Leprosy Day, promoting awareness, contact examination and stigma reduction.
What is Grade 2 disability?
Visible deformity — claw hand, foot drop, trophic ulcer, lagophthalmos — in a new case; reducing its proportion is the core early-detection indicator.
What is single-dose rifampicin post-exposure prophylaxis?
Chemoprophylaxis given once to eligible contacts of new cases to lower their risk of developing leprosy.
What is Nikusth?
The NLEP's online portal for cases, treatment, disability and campaign data; not to be confused with Nikshay, the tuberculosis portal.