03151nas a2200217 4500000000100000008004100001260001600042653001300058653003000071653000900101100001400110700002000124700001100144700001800155700001300173245006200186856011500248490000700363520254900370022001402919 2025 d bElsevier BV10aPakistan10aZero leprosy transmission10a20301 aPandey BD1 aMyat Ngwe Tun M1 aKita E1 avan Brakel WH1 aMorita K00aPakistan on the road to zero leprosy transmission by 2030 uhttps://www.thelancet.com/journals/langlo/article/PIIS2214-109X(25)00230-X/fulltext?dgcid=raven_jbs_etoc_email0 v133 a

Despite being a curable disease, leprosy affects an estimated 3–4 million people globally, leading to disabilities each year, with 182 815 new cases documented across 184 countries in 2023.^1,2 Considerable strides have been made in reducing its prevalence as a public health issue, achieving elimination rates to fewer than 1 case per 10 000 population in most countries by 2010.¹ In 1996, Pakistan officially declared the elimination of leprosy as a public health concern. However, as expected, new cases still occur at subdistrict levels, even after national-level elimination has been achieved. Weak surveillance hinders sustained elimination due to early diagnostic challenges, particularly in paucibacillary cases that require clinical signs, laboratory tests, and specialist expertise, which are now increasingly scarce. Before 2001, incidence and prevalence data were limited to the national level, making comprehensive comparisons difficult, with child proportion and grade 2 disabilities not calculated. Since 2001, more detailed information have become available, allowing the analysis of additional indicators such as child proportion and new patients with grade 2 disabilities at national and provincial levels. In The Lancet Global Health, the extensive dataset and diverse patient population in the study by Muhammed Iqbal and colleagues³ provide a strong foundation for interpretation. The analysis offers valuable insights with substantial implications for policy makers to sustain efforts to reach the milestones of interruption of transmission and elimination of leprosy disease and, eventually, achieve non-endemic status.⁴ Incorporating regional incidence and prevalence enhances the study's depth, making it a robust resource for leprosy research. Notably, the findings could serve as a useful model for other regions striving for leprosy elimination.

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