Novartis, a global healthcare company, has renewed its pledge with the World Health Organisation (WHO) to work to end leprosy by extending its donation of multidrug therapy (MDT) medicines to treat leprosy through the year 2020. This five-year agreement includes treatments worth more than USD 40 million and up to USD 2.5 million to support the WHO in handling the donation and logistics. Overall it is expected that the programme will reach an estimated 1.3 million patients during the next five years. This is part of the company's commitment in 2012 to the London Declaration on Neglected Tropical Diseases.

"Leprosy is a treatable disease and multidrug therapy remains the cornerstone of the global leprosy elimination strategy," said Joseph Jimenez, CEO of Novartis.

"We are proud to continue our work with the WHO to provide free treatment to leprosy patients worldwide. We also remain committed to our ongoing collaboration with governments, international agencies, NGOs and the private sector to bring leprosy back onto the global health agenda and work toward our common goal of making leprosy history."

Novartis and the Novartis Foundation, a philanthropic organisation pioneering innovative healthcare models, have a long-term commitment to leprosy treatment and control. Since 2000, Novartis has donated more than 56 million blister packs valued at approximately USD 90 million through the WHO, helping to treat more than six million leprosy patients worldwide.

The Novartis Foundation has been active in the fight against leprosy for nearly 30 years, previously focusing on innovative social marketing programs to reduce the stigma attached to leprosy and supporting patient rehabilitation.

In 2014, the Novartis Foundation launched a new leprosy elimination strategy developed with the top leprosy and disease elimination experts. The programme includes four pillars: early detection and treatment, contact tracing and preventative treatment, surveillance and response and the development of diagnostic tools for faster and earlier diagnosis. The Novartis Foundation also helps to facilitate the logistics of the MDT donation with the WHO.

LPEP (Leprosy Post-Exposure Prophylaxis), a key programme in the new strategy, has recently launched in India, Indonesia, Myanmar, Nepal and Tanzania, with a pilot in Sri Lanka planned for launch later this year. LPEP is designed to decrease the risk of developing leprosy, and reduce further transmission of the mycobacteria causing the disease. In this project, being done in collaboration with International Federation of Anti-Leprosy Associations (ILEP) partners,  the family, friends and other contacts of newly diagnosed patients are examined for leprosy and provided treatment if they also have leprosy, or preventative therapy if they are asymptomatic. This could decrease the risk of contacts developing leprosy in the years following contact by as much as 50-60 per cent.

Multidrug therapy (MDT) consists of three drugs (rifampicin, clofazimine and dapsone), two of which (rifampicin and clofazimine) were developed in the research laboratories of Novartis in the 1980s. Multidrug therapy has made it possible to treat patients, interrupt the transmission of leprosy and prevent disabilities. Even some patients with the severest form of the disease show visible clinical improvement within weeks of starting treatment.

Significant progress in the fight against leprosy has been one of the greatest public health successes. Global figures from WHO on leprosy highlight these early successes, showing that the global burden of leprosy has been reduced by 95 per cent since the 1980s. This is due in large part to the widespread availability of MDT which has reached 16 million patients since 1981.

However, the case detection rate (incidence) for leprosy has now plateaued at about 200,000-250,000 new diagnoses per year over the past 10 years and the disease remains endemic in high-burden pockets in many countries in Asia, Africa and Latin America.

New diagnoses occur in children as well as adults, which suggests continued transmission of the disease, and a large proportion of patients are diagnosed late and often with severe disabilities.

The challenge of the last mile in the fight against leprosy is to interrupt transmission.