You could be forgiven for thinking that leprosy is a disease of the past. For many Nepalis, the last time it entered mainstream conversation was more than two decades ago, when veteran comedy duo Madan Krishna Shrestha and Hari Bansha Acharya appeared in a widely broadcast public awareness advertisement.

In 2066 BS (2009/10 AD), the Government of Nepal declared leprosy eliminated as a public health problem at the national level. The announcement marked a historic public health achievement. But elimination does not mean eradication and today, leprosy remains a reality in Nepal.

What Does “Eliminated” Really Mean?– According to the World Health Organization (WHO), a disease is considered “eliminated as a public health problem” when its prevalence rate falls below 1 case per 10,000 population.

Nepal achieved this benchmark in 2066/67 BS, recording a prevalence rate of 0.77 per 10,000 people. However, in 2080/81 BS, that figure increased to 0.92.

While an increase in prevalence may sound alarming, experts say it is not necessarily bad news. A rising rate can also indicate improved case detection; meaning health services are successfully identifying previously hidden or undiagnosed cases.

Still, several districts across Nepal continue to report prevalence rates above 1 per 10,000 population. In these districts, leprosy has not yet been eliminated, signaling that the fight is far from over.

What Causes Leprosy?
– Leprosy is caused by a bacterium called Mycobacterium leprae. Contrary to long-standing myths, it is not highly contagious. In fact, most people have natural immunity to the bacteria.

Transmission typically requires prolonged, close contact over months or even years with an untreated individual. It does not spread through casual contact such as handshakes or sharing meals.

Recognizing the Early Signs
– Early detection is crucial.

Common symptoms include:

• Pale or reddish skin patches with loss of sensation
• Numbness or tingling in hands and feet
• Weakness in muscles

If left untreated, leprosy can cause nerve damage, leading to permanent disability and deformity. However, when identified early, such complications can be prevented.

The Good News: Leprosy Is Curable
– Leprosy is fully curable through Multi-Drug Therapy (MDT), which is provided free of cost across Nepal. Once treatment begins, the risk of transmission drops to virtually zero.

For individuals who have already developed complications, reconstructive surgery, physiotherapy, and assistive devices can significantly improve quality of life.

Why Awareness Still Matters
– For many people, leprosy feels distant; something unlikely to affect them personally. And for most, that may be true.

But national elimination requires sustained vigilance. Stigma, misinformation, and delayed diagnosis remain major challenges. The longer symptoms go unnoticed or ignored, the higher the risk of disability.

Nepal made history once by achieving elimination at the national level. To truly eliminate leprosy in every district, collective awareness and early reporting are essential.

Source: The Leprosy Mission Nepal

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