3,832 children diagnosed with leprosy as India targets interruption of transmission by 2027

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India’s child leprosy caseload was 91.6% above the NLEP’s target for 2025-26, with the WHO citing new child cases as an indicator of recent transmission. | Photo Credit: GettyImages/iStockphoto

India recorded 3,832 new leprosy cases among children in 2025-26, including 37 who had Grade-2 disability (G2D) at diagnosis — an indicator of delayed detection. The child caseload was 91.6% higher than the National Leprosy Eradication Programme's (NLEP) target of 2,000 cases for the year.

The figures, from the latest NLEP annual report for 2025-26, come even as India pursues the National Strategic Plan for Leprosy 2023-27, which seeks to interrupt transmission at the district level by 2027. Under the roadmap, a district is considered to have interrupted transmission after reporting zero new indigenous child cases for five consecutive years.

The NLEP's programme objectives include zero disability among new child cases and a national G2D rate of less than one case per million population. The roadmap projects 1,000 child cases and a G2D rate of 0.5 per million for 2026-27.

The appearance of children among newly detected cases matters beyond the absolute number. The World Health Organisation (WHO) considers new cases among children below 15 years an indicator of recent transmission, while G2D among newly detected patients indicates delayed diagnosis.

The WHO also says disabilities among newly detected child cases signal both delayed detection and ongoing transmission.

India recorded 63 children with G2D in 2019-20, followed by 35 in 2020-21, 41 in 2021-22, 55 in 2022-23 and 45 in 2023-24. The continued detection of children with G2D contrasts with the NLEP's objective of zero disability among new child cases.

The latest numbers therefore raise a fundamental epidemiological question: if India is working to interrupt transmission by 2027, why are children still developing leprosy, and why are some reaching diagnosis only after visible disability has appeared?

India detected 91,783 new leprosy cases in 2025-26, according to the Union Health Ministry. The prevalence rate was 0.56 per 10,000 population, and 1,945 patients had Grade-2 disability at diagnosis, accounting for 2.12% of all newly detected cases. The national G2D rate was 1.34 per million, above the NLEP's target of less than one case per million.

According to the WHO's latest global update, India reported the world's largest number of newly detected leprosy cases in 2025, with 91,783 cases, followed by Brazil with 22,901 and Indonesia with 16,292. Together, the three countries accounted for 78.3% of all new cases reported globally. The WHO notes that, although the update is for 2025, India reported data for April 2025 to March 2026.

India also reported the world's largest number of new child leprosy cases in the WHO's 2025 global update, with 3,832 cases.

The WHO figures and the NLEP figures refer to the same reporting period for India — April 2025 to March 2026 — although the WHO presents India's data in its 2025 global table. The WHO table records 3,832 child cases and 37 child cases with G2D for India.

Dr. Kabir Sardana, Professor and Head of Dermatology at ABVIMS-Dr. RML Hospital, Delhi, attributed the continuing burden partly to gaps in case detection.

"Data points to the fact that there is poor detection, which is why we are seeing more children with leprosy," he said.

The Health Ministry identifies high-endemic and hard-to-reach areas as priorities for intensified case detection. The NLEP emphasises active case detection, household contact surveys and focused campaigns, along with special plans for hard-to-reach areas. The programme also identifies stigma and discrimination as continuing concerns.

The WHO says prolonged, close contact with untreated cases allows transmission to continue, while the disease's long incubation period makes interruption difficult. New child cases are considered an indicator of recent transmission, although the presence of a child case cannot by itself establish when or where the infection occurred. The WHO notes that symptoms can appear years after infection.

Leprosy, or Hansen's disease, is a chronic bacterial infection caused mainly by Mycobacterium leprae. It primarily affects the skin and peripheral nerves. Transmission occurs mainly through prolonged, close contact with an untreated person. The disease is curable with multidrug therapy, a combination of antibiotics provided free through public-health programmes.

Children and household contacts are particularly important to surveillance because a new child case can indicate ongoing transmission within a community. However, the presence of a child case cannot by itself establish when or where the infection occurred. The average incubation period is about five years and can be considerably longer.

India's child caseload has fallen substantially from a decade ago, but the decline has not been linear. The country detected 11,365 children with leprosy in 2014-15, 11,389 in 2015-16 and 11,770 in 2016-17. The number fell to 10,287 in 2017-18, 9,227 in 2018-19 and 7,859 in 2019-20.

Child detections fell sharply during the COVID-19 period, reaching 3,753 in 2020-21, before rising to 4,107 in 2021-22. They fell again to 2,363 in 2022-23 and 2,335 in 2023-24, before rising to 3,832 in 2025-26. Changes in reported case numbers also reflect the intensity and reach of case detection, making it difficult to interpret the trend as a direct measure of transmission alone.

The Health Ministry has identified high-priority States and districts where the burden remains concentrated. Twenty-three districts in Chhattisgarh, 21 in Jharkhand, 18 each in Maharashtra and Odisha, and 10 in Madhya Pradesh had a prevalence rate above one case per 10,000 population, according to the Ministry.

These figures identify districts with prevalence above the elimination threshold; they should not be read as meaning that these are the only States or districts with continuing transmission.

For a disease that is curable, and for which early detection and treatment can prevent the progression to disability, the continued detection of children — including some already showing Grade-2 disability — highlights the tension between programme targets and what is still being detected in communities.

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