Nepal has achieved the elimination of leprosy as a public health problem in December 2009 and declared elimination in 2010. Department of Health Services acknowledged the achievement as one of the major success stories of the health sector in the past decades. Although significant progress has been made in reducing the disease burden at national level, sustaining the achievement & further reducing the disease burden through delivering quality leprosy services still remain as major challenge.

After meeting the elimination target at national level, the national strategy was revised to “Sustain Quality Leprosy Services and Further Reduce the Disease Burden due to Leprosy in Nepal: 2011-2015″ based on the “Enhanced Global Strategy for Further Reducing the Disease Burden Due to Leprosy: 2011-2015″ and the updated national Operational Guideline is developed based upon WHO guideline. The main principles of leprosy control are based on early detection of new cases and timely treatment with multi-drug therapy (MDT) through integrated health services. Major target for 2020 is to reduce grade II disability below 1 per million.

Goal, objectives, strategies and targets of the leprosy control programme

Vision: Leprosy free Nepal

Guiding principles

• Stewardship and system strengthening
• Expedite the elimination process in high prevalence districts
• Collaboration, coordination and partnership
• Community involvement
• Integration, equity and social inclusion
• Linkages with Universal Health Coverage and Sustainable Development Goals

Strategies

1. Expand and Enhance early case detection through selected diverse approaches (ISDT)
2. Strive to achieve the surveillance performance indicators
3. Modernize and intensify the service delivery pathways for ensuring quality services
4. Heighten the collaboration and partnership for Leprosy-Free Nepal
5. Enhance support mechanism for people infected and affected by leprosy

Evolution and milestones of leprosy control Programme in Nepal
The establishment of the Khokana Leprosarium in the nineteenth century was the beginning of organized leprosy services in Nepal. Key leprosy control milestones since 1960 are:

• 1960: Leprosy survey by Government of Nepal in collaboration with WHO
• 1966:  Pilot project to control leprosy launched with Dapsone monotherapy
• 1982 :  Introduction of multi-drug therapy (MDT) in leprosy control programme
• 1987 :  Integration of vertical leprosy control programme into general basic health services
• 1991 : National leprosy elimination goal set
• 1995 :  Focal persons (TB and leprosy assistants [TLAs]) appointed for districts and regions
• 1996 : All 75 districts were brought into MDT programme
• 1999/2000–2001/02 : Two rounds of National Leprosy Elimination Campaign (NLEC) implemented
• 2008 : Intensive efforts made for achieving elimination at the national level
• 2009 and 2010 :  Leprosy elimination achieved and declared at the national level
• 2011 : National Leprosy Strategy (2011–2015)
• 2012-2013 : Elimination sustained at national level and national guidelines, 2013 (2070) revised
• 2013-2014 :  Mid-term evaluation of implementation of National Leprosy Strategy (2011-2015)
• 2014-2015 :  Ministry of Health designated LCD as the Disability Focal Unit
• 2017 :  Policy, Strategy and 10 Years Action Plan on Disability Management (Prevention, Treatment and Rehabilitation) 2073-2082 developed and disseminated.