Global leprosy (‎Hansen disease)‎ update, 2024: Beyond zero cases – what elimination of leprosy really means

The Global Leprosy Strategy 2021–2030,1 which is aligned with the Neglected tropical diseases road map 2021–2030,2 brings into focus the new paradigm with elimination of leprosy disease. Two issues were identified from the previous leprosy control efforts: need for an approach which is subnational level upwards to achieve disease elimination and importance of a robust post-elimination surveillance.

This insight was used to develop a comprehensive leprosy elimination framework (LEF), described in WHO technical guidance on interruption of transmission and elimination of leprosy disease,3 issued in 2023. The framework consists of 3 phases: up to interruption of transmission; interruption of transmission until elimination of leprosy disease; and post-elimination surveillance.

To implement this approach, the WHO Global Leprosy Programme developed 2 complementary tools, the Leprosy elimination monitoring tool (LEMT) and the Leprosy programme and transmission assessment (LPTA) tool. The LEMT through a “traffic light” scheme corresponding to the LEF, provides a visual representation of progress across the phases of elimination both nationally and subnationally. The LPTA tool provides a set of programmatic criteria for complementing the epidemiological achievement demonstrated by LEMT. This comprehensively covers all aspects of a leprosy programme, defined under political commitment, programme implementation and surveillance. WHO uses these tools to verify that a country has achieved elimination of leprosy disease.