The National Leprosy Control Programme (NLCP) has been in operation since 1955 as a centrally aided programme to achieve control of leprosy through early detection of cases and DDS (dapsone) monotherapy on ambulatory basis. The programme gained momentum during t he fourth Five Year Plan after it was made a centrally sponsored programme. In 1980 t he Government of India declared it s resolve to “eradicate” leprosy by the year 2000 and constituted a Working Group to advise accordingly. The Working Group submitted it s report in 1982 and recommended a revised strategy based on multi-drug chemotherapy aimed at leprosy “eradication” through reduction in the quantum of infection in the population, reduction in t he sources of infection and breaking the chain of transmission of disease. In 1983 the control programme was re designated National Leprosy “Eradication” Programme with the goal of eradicating the disease by the turn of the century. The aim is to reduce case load to 1 or less than 1 per 10,000 populations. 

Strategy: 

The revised strategy is based on early detection of cases (by population surveys, school surveys, contact examination and voluntary referral), short term multi-drug therapy and health education and deformity care and rehabilitation activities. The regimens recommended by WHO have been adapted to suit the operational and administrative requirements. 

NLEP provides free domiciliary treatment in endemic districts through specially trained staff, and in moderate to low endemic districts it provides services through mobile leprosy treatment units and primary health care personnel. Treatment of leprosy case with MDT was taken up in a phased manner. As a result number of cases discharged as cured is increasing progressively over the years. 

Modified Leprosy Elimination Campaign (MLEC): 

A mid-term appraisal of the programme in April 1997 indicated that while the progress of the programme is satisfactory at national level, it is uneven in some states. It was decided to launch a leprosy elimination campaign by giving short term orientation training in leprosy to health staff including medical officer, health workers and volunteers (9.36 lakh health workers were trained); increase public awareness about leprosy; and house to house search has been conducted to detect new leprosy cases throughout the country by 5.83 lakh searchers for a period of six days. This first round of campaign led to detection of 2.9 million suspected cases of leprosy of which 0.464 million were confirmed to have leprosy. 32.6 percent were multi-bacillary leprosy and 13 percent of single skin lesion. Later on it was decided to further intensify community awareness and training of general health care workers as part of second round of MLEC. 

The WHO has set a new target of elimination of leprosy by the year 2005 and has formed a Global Alliance for Elimination of Leprosy. 

In the field of leprosy eradication, there is considerable element of foreign assistance from international agencies, viz., SIDA, DANIDA, WHO, UNICEF, Damien Foundation etc. It is understood that presently about 284 voluntary organizations in the country are actively engaged in anti-leprosy activities, supplementing the governmental effort. With the inclusion of leprosy eradication in the 20 point programme, a new thrust has been given both for expansion and monitoring activities. 

Elements of the programme:

1. Decentralized integrated leprosy services through the general health care system

2. Capacity building of all general health services functionaries

3. Intensified information, education, and communication

4. Prevention of disability and provide medical rehabilitation 

5. Intensified monitoring and supervision

For eradication of leprosy in a rural area, a special action plan for eradication of leprosy and for urban areas, continuous surveillance for leprosy eradication (CSLE) activities is formed. By these activities, early identification and Medical treatment can be provided in outer parts of urban areas and slums.

Major initiatives:

1. More focus has been given on the identification of new cases 

2. In this, calculate the complete annual treatment rate of every state.

3. More focus has been given on the prevention of disability occurrence and medical rehabilitation of the patient.

Aids provided for the Program:

1. Provided dressing material, medicine, and ulcer kits.

2. Provided microcellular rubber footwear for protection of insensitive feet.

3. An amount of Rs. 5000 is provided as an incentive to each leprosy patient of the BPL family.

4. Financial support of 5000/- rupees also provided to government institutions and PMR centres per reconstructive surgery conducted.

Objectives of the programme in 12th Five-Year Plan:

1. Elimination of leprosy, reducing the prevalence of less than 1 case per 10,000 population in all districts of the country.

2. Strengthen disability prevention and medical rehabilitation of leprosy patients.

3. Reduction in the level of stigma associated with leprosy.

Programme strategy:

1. Integrated leprosy services through the general health care system.

2. Early detection and complete treatment of new leprosy cases.

3. Carrying out a household contact survey for early detection of cases.

4. Involvement of ASHA in the detection and completion of treatment of the patient on time.

5. Strengthening of disability prevention and medical rehabilitation services.

6. IEC activities in the community to improve self-reporting to PHC and reduction of stigma. 

7. Intensive monitoring and supervision at PHC and CHC.