For World NTD Day (30 January 2026), Lepra is reminding the world that investing in Neglected Tropical Diseases (NTDs) is a global imperative. At no other point in history have we been better equipped to address NTDs with the knowledge, resources and innovations that are accessible today.
As we increase country ownership of NTD interventions and build internal resource resilience that moves away from dependence on external aid, the knowledge and experience of our in-country and community champions are our greatest assets.
Therefore, it is essential that we celebrate the successes achieved, acknowledging that with greater investment, strong country leadership and national commitment our in-country champions can be supported to amplify their impact further.
We are pleased to spotlight the work of our team in Bihar. LEPRA Society’s state co-ordinator in Bihar, Rajni Kant Singh shares how their work is supporting communities through alleviating the impact of lymphatic filariasis.
Rajni explores themes of integration, community engagement and social inclusion, and how a holistic and combined approach is testament to continued success.
Lymphatic filariasis (LF), commonly known as elephantiasis, is one of the leading causes of disability from a tropical disease, affecting 51 million people globally. LF is caused by parasites that are transmitted to humans through mosquitoes, and infection is usually acquired in childhood, causing hidden damage to the lymphatic system.
Without treatment, LF can later develop into visible manifestations such as lymphoedema, elephantiasis and scrotal swelling, which may then lead to permanent disability. Persons affected may also experience additional mental, social and financial challenges impacting their overall wellbeing. Therefore, LF requires an integrated approach that addresses both the medical and social needs associated with the disease.
Here is what LEPRA Society are doing to positively impact those affected by lymphatic filariasis:
Integration with other skin NTDs allows Lepra to show how combined resources can have a wider and more far-reaching impact on NTD affected communities. LEPRA Society’s LF programme first began in 2005 in the Puri district of Odisha, later expanding to Bihar in 2009 as part of an integrated model with leprosy in collaboration with India’s National Vector Borne Disease Control Programme (NVBDCP).
LEPRA Society has been able to leverage evidence-based strategies from leprosy and adapt them to persons affected by LF. This includes home-based self-care delivered by integrated referral centres and mobile foot care units. LEPRA jointly supports persons affected by both leprosy and LF, providing tailor-made footwear, compression support and physiotherapy.
Applying proven, evidence-based strategies from leprosy programmes to LF represents a high-value investment, demonstrating how integrated approaches can strengthen care across multiple diseases. This is especially relevant in remote or rural communities, where limited resources, including trained healthcare providers, must serve more communities across greater geographies.
Where integration is truly exemplified is through the ASPIRE project in partnership with Canadian global health organisation Effect Hope, and its active case-finding for skin-related NTDs. In Jamui state, Bihar, five skin NTDs are commonly found in the community including leprosy, LF, cutaneous leishmaniasis, post-kala azar dermal leishmaniasis and scabies. ASPIRE not only models a combined approach to early case detection and determines prevalence of diseases but also leads on awareness campaigns and the training of healthcare workers on all 5-NTDs.
Across all aspects of LEPRA Society’s work, the message is clear. Integration shows how health outreach and education can be made stronger, more efficient and more sustainable.
Community engagement is a cornerstone of NTD interventions, and communities are integral to developing health systems that can sustain efforts beyond the achievement of elimination goals. Capacity building is a core component of this approach, allowing for continued sustainability of LEPRA Society programmes beyond their end.
In Bihar, India, LEPRA Society has supported over 250 self-support groups (SSGs). SSGs are small, voluntary associations of individuals that offer support in relation to both health and emotional needs. Members collaboratively address social discrimination and uplift livelihoods through skills training, improving economic opportunities and providing access to essential services. LEPRA supports community-led development by facilitating the training of community leaders to support their peers in advancing disability rights and accessing social entitlements, thereby reducing the social and economic impacts of LF.
It is estimated that 25 million men affected by LF are impacted by hydrocele and often require surgery to reduce swelling. Hydrocele is characterised by the accumulation of fluid in the scrotum and can have both a social and economic impact. Many of those affected are unable to work due to the discomfort and may experience intense shame, social withdrawal and emotional distress due to the visible nature of the condition.
As LF and other NTDs disproportionately affect rural and marginalised communities, attracting and retaining skilled surgeons to low-resource settings often requires financial incentives. In partnership with the local government, LEPRA Society worked closely with the local government to support the introduction of an incentive-based programme for surgeons. Since the start of this programme more than 26,000 surgeries have been completed over a period of 2 years. These incentives are not just about increasing surgical numbers but are also an investment in restoring health, dignity and economic participation.
Community members are often inspired to engage with the health system once they are exposed to the far-reaching impact of life-changing surgery and the social and economic benefits available to them. Overtime, this builds community trust and encourages more persons affected to engage with the services available to them.
As part of community engagement, LEPRA Society is supporting persons and communities affected by lymphatic filariasis in accessing social entitlements. A historic milestone came in 2022, when the Government of India officially recognised LF as a disability under the persons with disabilities act (2016), providing access to the disability pension scheme of 1100 rupees (8.78GDP) per month. This recognition also unlocked access to health insurance and other welfare schemes through the provision of unique disability identity cards.
LEPRA Society has supported communities to register with these schemes. In collaboration with frontline workers such as Accredited Social Health Activists (ASHAs) Jivika’s and village volunteers, rapid inquiry surveys have identified LF cases causing disability and supported their referral to PHCs for government records. LEPRA are then able to advise and support those affected in registering online for disability identity cards (UDID), unlocking access to a range of social welfare schemes. LEPRA Society also provide training on online tools used to access these benefits, as well as aiding with any follow-up needed with individual social welfare/health departments or local development officers.
Ultimately, the approach outlined above adopts a holistic and community-centred focus, acknowledging that persons affected by lymphatic filariasis are pivotal in the design and implementation of our programs. By engaging the wider community in all-levels of our outreach, we can build a healthcare system rooted in trust, accountability and mutual support.
In addition, positive health outcomes are best achieved when systems address and respond to the broader social, economic, and environmental factors that shape people’s ability to access care, participate fully, and realise their rights.
