Regional Director’s opening remarks at the Seventeenth Meeting of the WHO Technical Advisory Group on Leprosy Control, 29 November

Chair, experts in leprosy, programme managers, representatives of the International Federation of Anti-Leprosy Associations Technical Commission, persons affected by leprosy, WHO colleagues, ladies and gentlemen,

It is with great pleasure that I welcome you to this seventeenth meeting of the Technical Advisory Group (TAG) on Leprosy Control – the first such meeting since the launch of our new Global Leprosy Strategy 2021–2030.

Whereas previous strategies focused on the “elimination of leprosy as a public health problem”, our new strategy aims to interrupt leprosy transmission and achieve zero leprosy disease, zero disability, and zero stigma and discrimination – targets that are ambitious but achievable.  

The Strategy redefines the burden of leprosy not only to include persons in need of physical treatment and rehabilitation, but also those suffering from the mental health impact of leprosy.

It highlights the importance of equitable access to leprosy prevention though post-exposure prophylaxis with a single dose of rifampicin, which must complement active case finding for early diagnosis.

The Strategy aims to achieve sustained reductions in the world’s 23 high-burden countries, while interrupting transmission in countries that currently report very few cases.

It is aligned with the new NTD Roadmap 2030 and will help achieve several Sustainable Development Goal (SDG) targets, including target 3.3 and the overall SDG mission: Leave no one behind.

It was developed in consultation with a range of stakeholders, including affected communities, and marks a paradigm shift not only in how we think about elimination, but in how we aim to achieve it.

And let us be clear: What today is possible is possible only because of the steadfast commitment and steely resolve that key leprosy stakeholders – including this TAG – have demonstrated over so many years.

In 2019 more than 200 000 cases of leprosy were detected from 116 countries globally, of which 96% were from 23 high-burden countries.

Less than 5% of cases had grade-2 disability (G2D) at the time of diagnosis, equating to a G2D rate of 1.4 per million population – a 27% reduction on the 2014 figure.

Globally, the new case detection rate for those aged 0 to 14 years was 7.9 per million children, marking a significant improvement on the 2014 rate of 10.1. 

To date, more than 17 million patients globally have been treated with multi-drug therapy, and most countries have eliminated leprosy as a public health problem.

Need it be said: The COVID-19 pandemic has disrupted essential health services globally, including services to prevent, detect and treat leprosy. 

In 2020, more than 127 000 new leprosy cases were reported, of which 7% were children. Another 6% were cases of delayed diagnosis with visible deformities at the time of diagnosis.

Notably, new case detection in 2020 was 37% lower than in 2019 – not because cases had reduced, but due to a series of operational challenges, such as restrictions on travel and the repurposing of staff.   

But there is a silver lining, which is that throughout the COVID-19 response, treatment completion rates are reported to have been maintained.

I congratulate health workers and leprosy programme staff for achieving that outcome, which will help us begin implementing our new Strategy from a position of strength.

Several months ago, I requested the Global Leprosy Programme to work closely with countries over the next biennium, with a specific focus on helping them develop national strategic plans (NSPs) to implement the Strategy.

Over the course of this meeting, your insights will help facilitate that process, including by informing our efforts to create a global NSP template.

At the same time as addressing leprosy prevention, detection and treatment, I urge you to consider how best countries can increase access to assistive devices and mental health services, both of which are essential to improving social and economic participation among people with G2Ds and mental health issues associated with leprosy.

In addition, I request this TAG to review criteria on achieving interruption of leprosy transmission, and to help define tools and methodologies for verification. 

I look forward to your guidance on how together we can enhance research on improved diagnostics and treatment regimens, both of which are central to the new Global Leprosy Strategy.

I thank you for your participation, wish you engaging and insightful discussions, and look forward to your recommendations.

Thank you.