The national leprosy eradication programme in India

India has the largest leprosy problem in the world, with an estimated 4 million patients. The number of registered cases in the country was 2.4 million by June 1990, and the number of new cases detected during 1989-1990, 0.47 million. The disease prevalence varies widely from state to state and even among districts within states--8 of the 26 states contribute to 90% of all the registered cases. The country has a high priority for leprosy and the National Leprosy Eradication Programme (NLEP) aims to arrest the disease among all known cases in the country by the turn of the century through a strategy which includes multidrug therapy (MDT), early case detection, health education and rehabilitation. The specialized leprosy infrastructure in the country has a total of about 8,500 establishments including 719 leprosy control units, 244 district leprosy units and 49 training centres. By June 1990, 130 districts with 2.15 million patients had come under MDT. It is planned to cover 196 districts by 1992, ensuring coverage for 90% of the patients in the country. The country spends approximately 600 million rupees (US$ 33.3 million) per year on NLEP. In addition, a number of bilateral and international agencies including nongovernmental organizations participate in the programme. WHO supports the NLEP through technical inputs, monitoring and evaluation, and training. Plans to integrate leprosy control within primary health care, particularly after completion of the intensive phase of MDT, are being developed. Operational and technical constraints are constantly reviewed in order to find optimal solutions.