By Becks Hill - Lepra's Director of Programmes and Advocacy
The much-anticipated 2024 leprosy data from the World Health Organization (WHO) landed in our inboxes last week.
It is no easy task assimilating data from 188 countries from the 6 WHO regions, for a defined period, especially when reporting periods differ. For example, India submitted data from April 2024-March 2025, and Canada for 2023, complicating the aggregation process further. That aside, what the data indicates is that there is a continuing downward trend in new case detection. 182,815 new cases detected in 2023, to 172,717 in 2024. The graph below from the report reflects a steady decline over the past decade (2020-23 was during the period of the Covid-19 pandemic, in which it is widely acknowledged that under-reporting of new cases was an issue). The data also illustrates that geographical concentrations can be found in India, Brazil and Indonesia, accounting for nearly 80% of the total number of new cases of leprosy worldwide, and the Southeast Asia Region SEAR accounting for 72% of the total number of new cases. View the report and data here.
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A deeper dive reveals that of that total, 69,394 were women (42.2%), and 9,157 were diagnosed with grade 2 disability (GD2), 9,397 were children (5.4%), with 289 of those GD2 cases occurring in children. Over the last decade, the rate of detecting leprosy among children has roughly halved, falling from 9.9 per 100,000 children in 2015 (465 in a population of 4.7m), to 4.7 per 100,000 children in 2024 (220 children).
Recognising progress vs unfinished business - what the data means.
With all this data indicating a clear decline in case numbers, it would be natural to think that this positive trajectory could soon lead to leprosy being a disease of the past. However, now is not the time to be complacent. Behind all these numbers are people; people who are living with the daily impact of their diagnosis, and millions of people who are yet to be diagnosed.
With the global elimination agenda in the early 2000s, many programmes scaled back, and millions of cases were left undetected. Today, an estimated four million are still missing from the statistics, they are living with leprosy without a diagnosis nor treatment, allowing the disease to continue to spread. Comparative to other diseases the actual case numbers may appear underwhelming but an estimated 2-3 million people live with leprosy related disabilities, implying either a diagnosis not made in time, or delays in the provision of treatment.
With children still representing over 5% of the overall global new case numbers, it is a warning sign that progress may still be too slow. When children are found to have leprosy, it denotes recent infection and indicates that leprosy is being actively transmitted in the community. It means that when children are diagnosed, it is a sign of ongoing transmission and there is a need for more efforts to be made to detect cases early. Furthermore, when a person is first diagnosed and they already have G2D, it means that they have been missed for too long. Had they been diagnosed earlier, they would have been treated, and disability would have been averted. The stark reality is, that of the new cases being diagnosed who have G2D, there has been a tragic delay in diagnosis, and the disease has already gripped the person affected and caused lifelong disability. 5.4% of G2D was found in children, which means that awareness, detection, and treatment efforts need to be ramped up. Had leprosy been found earlier, these children would have avoided unnecessary disabilities.
The data on reactions highlights the issue that some people affected by leprosy can have painful swelling or redness in the skin and nerves - a 'reaction', which needs prompt treatment to prevent damage. Additionally, the medicines that treat and cure leprosy called 'multidrug therapy' (MDT) which are provided under the free donation scheme by Novartis, are a remarkable example of a public-private partnership. However, these drugs are not without their hazards and like all medications, they can have notable side effects.
Hidden behind the metrics
What the data does not show are the countless people still living with the physical, social, and emotional impact of leprosy. For people affected, the implications reach far beyond a diagnosis, causing long-term physical impairments and disabilities, emotional and mental distress, social exclusion, and economic hardship.
Nor does the data reveal that while children make up 5% of new cases, only those over 10 years old have access to age-specific MDT blister packs through the Novartis donation programme. This forces clinicians and community health workers to adapt adult medicines, splitting uncuttable tablets, opening capsules, and too often risking misdosing in small children.
The data does not capture the lived realities: children dropping out of school, adults losing their jobs, or people suffering injuries because the nerve damage leprosy causes has taken away their body’s natural warnings. Behind every number is a story of exclusion, lost opportunity, and resilience.
Nor does the data reflect the many discriminatory laws that still deny equality to people affected by leprosy. While 81 such laws have been formally reported to the WHO, the International Federation of Anti-Leprosy Associations (ILEP) indicates there are at least 141 still in force worldwide. These laws segregate, block employment, restrict access to services, and strip away basic human rights. Even today in 2025, leprosy remains legal grounds for divorce in parts of India, disqualifies people from standing for election, or bars them from residency in countries such as Thailand. From Singapore to Namibia, India to the UAE, Australia to the Bahamas, outdated laws exist designed to exclude rather than include.
The data alone does not tell these stories.
Continued efforts needed
So yes, the latest figures are fantastic news, and we celebrate and laud all efforts that have contributed to this continued downward trend. At Lepra we are proud to share in this success. At the same time, it is equally important to remember that behind the numbers, too many people are still living with the consequences of preventable disabilities, and that our continued efforts remain needed and essential.
In 2024, Jordan became the first country to declare leprosy eliminated, a milestone that does not come without complexity. Diagnosis, treatment, and management are complex, requiring specialist skills and resources. Even when elimination is declared, the story does not end. Behind the treatment doors, there lies a long and winding corridor of geo-political pressures that can lead to data being skewed, underreporting, and health system gaps, while people continue to face stigma, lost livelihoods, and persistent inequities.
Time to ramp up support
With major funding streams dwindling, it would be easy for leprosy to be dwarfed by disease giants such as tuberculosis or malaria, but leprosy must not be overlooked. If it is, the reality is that we risk reversing our hard-fought gains. Fewer new cases do not mean we should treat leprosy with any less importance. Millions are already living with permanent disability, and the stigma and discrimination associated with leprosy continue to drive exclusion and poverty.
Lepra remains committed to ramping up efforts to address these issues and to seek out the 'missing millions' of hidden cases. We must continue to break down societal barriers that are divisive and constrict the inclusion of people affected by leprosy from contributing to and being part of their communities as equal and respected members. We will continue to be a part of the solution and ensure that the downward trend of the last decade leads to dignity, inclusion and freedom from leprosy-related disability and stigma for every person, family and community still impacted by leprosy.
*[Figure 2 graph - Trends in new leprosy cases]. [https://iris.who.int/bitstream/handle/10665/382657/WER10037-365-384.pdf?sequence=1]: World Health Organization; [2025]. Licence: CC BY-NC-SA 3.0 IGO.
