Leprosy is an ancient disease shrouded in stigma and misconceptions. It continues to be a public health challenge in some parts of the world. National Leprosy Day is observed on January 30 and we spoke to Dr Amit Dias, to get skin deep into the disease. He says, “It’s time to unite, act and eliminate leprosy. We need to give it the final push and this can happen by raising awareness about the disease.
An Q/A interview with Dr Amit Dias on World Leprosy Day
Goan Observer: Let’s begin by understanding the term leprosy.
Dr Amit Dias: Leprosy is derived from the Greek word “lepros” which means “scaly.” Leprosy was first linked to a bacterium by Gerhard Hansen in 1873, making it one of the first diseases with a known microbial cause. It was a groundbreaking discovery at the time. For this reason, it is also known as Hansen’s disease. This bacterium primarily affects the skin, peripheral nerves, and mucosa of the upper respiratory tract, as well as the eyes. The disease progresses slowly, and symptoms can take years to appear.
Historically, leprosy has been feared because of its disfiguring symptoms, lack of effective treatment in ancient times, and the stigma surrounding it. It was misunderstood as a curse or punishment, leading to discrimination against those affected. We need to fight the misconceptions, fight stigma and join hands to eliminate leprosy. National Leprosy Day which is observed on January 30 coincides with the death anniversary of Mahatma Gandhi.
Q: What is the connection between leprosy and Mahatma Gandhi?
A: Mahatma Gandhi worked tirelessly to eliminate the stigma surrounding leprosy. He cared for individuals affected by the disease, challenging societal prejudices. Gandhi’s work emphasized compassion and equality, inspiring leprosy control programs in India.
Q: That’s very interesting history. How does the disease spread? Is leprosy contagious?
A: Leprosy is mildly contagious. It spreads through prolonged close contact with an untreated person, likely via respiratory droplets. However, more than 95% of people have a natural immunity to the disease, and with early detection and treatment, transmission can be interrupted.
Q: The theme for World Leprosy Day 2025 is “Unite,Act,Eliminate.” Could you elaborate on its significance?
A: The theme emphasizes urgency and collective action. According to the World Health Organization (WHO), ending leprosy involves:
- Increasing awareness about the disease to reduce stigma.
- Strengthening early detection and prompt treatment to interrupt transmission.
- Supporting research and innovation to tackle drug resistance and improve diagnostics.
The theme reminds us that leprosy is preventable and curable, and achieving its elimination requires collaboration among governments, healthcare providers, and communities.
Q: What do we mean by the elimination of leprosy?
A: The elimination of leprosy, as defined by the WHO, refers to reducing the prevalence of the disease to less than one case per 10,000 people. Many countries, including India, have achieved this goal at the national level. However, elimination at the sub-national level — particularly in high-burden areas — remains a challenge.
We have managed to eliminate leprosy from Goa and most parts of the country after intense efforts. However, we need to continue the same as elimination does not mean the disease has been wiped out, it just means that the prevalence is low so transmission does not take place very easily. Leprosy can present in different forms- there is a spectrum that one needs to be aware of.
Q: Could you explain the spectrum of leprosy?
A: Leprosy manifests as a spectrum, depending on the immune response of the affected individual:
- Tuberculoid leprosy: Characterized by a strong immune response, fewer skin lesions, and limited nerve involvement.
- Lepromatous leprosy: Involves a weak immune response, widespread skin lesions, nodules, and severe nerve damage.
- Between these extremes lie borderline forms, which can shift toward either end depending on treatment and immunity.
The classification helps guide treatment and predict complications.
Q: What is the burden of leprosy?
A: Globally, around 200,000 new cases are reported annually, with India accounting for more than half of them. While India achieved elimination at the national level in 2005, some states and districts still report high case numbers. In Goa, the prevalence is low, we have managed to eliminate leprosy from the state. However, as I mentioned earlier, sporadic cases continue to occur, indicating the need for sustained surveillance and awareness.
Q: Yes surveillance is necessary. How can we recognize the signs of leprosy?
A: Early signs of leprosy include:
• Pale or reddish patches of skin with loss of sensation.
• Thickened peripheral nerves, often accompanied by muscle weakness or numbness.
• Numbness or tingling in the hands and feet.
Advanced cases may show nodules, ulcers, or deformities. It’s crucial to seek medical attention at the earliest sign to prevent complications.
If you notice any of these, please see a doctor and think of diagnosis.
Q: What are the complications of leprosy?
A: If untreated, leprosy can lead to severe complications, including:
• Permanent nerve damage, causing loss of sensation and muscle weakness.
• Deformities, such as claw hands or foot drop.
• Blindness due to damage to the eyes.
• Secondary infections, ulcers, and amputations.
Timely treatment can prevent most of these complications.
Q: Have we eliminated leprosy from India?
A: While India achieved the WHO-defined elimination target at the national level, pockets where it is endemic remains. Certain regions still report high case numbers, particularly among marginalized populations. Continued efforts are needed to address these disparities.
Q: What do religious texts say about leprosy?
A: Leprosy is an ancient disease and religious texts have made a mention of leprosy. It was viewed as a symbol of impurity, leading to the isolation of those affected. These historical references sometimes contribute to the stigma associated with the disease. However, modern medicine has shown that leprosy is a bacterial infection that can be treated and cured.
Q: Can leprosy be treated?
A: Yes, leprosy is curable with multidrug therapy (MDT), which is freely provided by the WHO. The treatment duration depends on the severity. Early treatment can prevent complications and halt transmission. The treatment is available free of cost under our health services. Early diagnosis and prompt treatment should be the goal.
Q: What are the barriers to leprosy elimination?
A: There are several barriers, the main barriers include:
• Stigma: Fear and discrimination prevent people from seeking care.
• Delayed diagnosis: Lack of awareness leads to late presentation.
• Healthcare gaps: Limited access to health services in remote areas.
• Social determinants: Poverty, overcrowding, and malnutrition increase susceptibility.
Addressing these barriers calls for a multi-sectoral approach.
Q: Finally, what is your message for World Leprosy Day?
A: The National leprosy Eradication program has introduced a mascot – Sapna who helps in raising awareness about leprosy. Each of us has a role to play in creating a world free of leprosy. My message is simple: Leprosy is preventable, treatable, and curable. We must “Unite and Act Now” to end stigma, ensure early detection, provide equitable access to treatment and eliminate leprosy.
