Content

1. Leprosy in India: The Road to a Disease-Free Future
2. ICG conducts 10th NATPOLREX-X & 27th NOSDCP off Chennai Coast

Leprosy in India: The Road to a Disease-Free Future

Why in News ?

• As of March 2025, India has sustained leprosy elimination status nationally with 31 States and 638 districts achieving prevalence rate <1/10,000 population.
• Leprosy prevalence dropped from 57.2 (1981) to 0.57 (2025) per 10,000 population — a 99% reduction.
• Child cases reduced from 9.04% (2014–15) to 4.68% (2024–25) — key indicator of interrupted transmission.
• India’s National Strategic Plan (NSP) and Roadmap for Leprosy 2023–27 aims for zero indigenous cases by 2030.

Relevance

• GS-2 (Health & Social Justice): NLEP, NHM integration, anti-discrimination, digital trackin (Nikusth 2.0), WHO alignment.
• GS-3 (Science & Tech): Vaccine research, AMR surveillance, ICT-based monitoring.
• GS-1 (Society): Stigma reduction, social inclusion, awareness campaigns.

What is Leprosy ?

• Causative agent: Mycobacterium leprae (chronic bacterial infection).
• Transmission: Respiratory droplets during prolonged contact with untreated patients.
• Organs affected: Skin, peripheral nerves, eyes, upper respiratory tract.
• Types:
  • Paucibacillary (PB): Few bacilli, mild infection.
  • Multibacillary (MB): High bacilli density, severe infection.
• Symptoms:
  • Discoloured skin patches, loss of sensation, non-healing ulcers, deformities in limbs and face.
• Treatment:
  • Multi-Drug Therapy (MDT) introduced in 1983: Rifampicin, Clofazimine, and Dapsone — provided free by WHO.
  • Prevents disability if diagnosed early.

Evolution of India’s Leprosy Programme

Phase I: Control (1955–1982)

• National Leprosy Control Programme (NLCP, 1955):
  • Focus on Survey, Education, and Treatment (SET).
  • Relied on dapsone monotherapy, provided through domiciliary care.
• 1970s: Became a centrally sponsored scheme during Fourth FYP.
• Strengthened NGO participation; house-to-house surveys and community education initiated.
• Prevalence in 1951: 38.1/10,000 (13.74 lakh cases).

Phase II: Eradication (1983–2004)

• National Leprosy Eradication Programme (NLEP, 1983):
  • Integration of MDT (endorsed by WHO, 1982).
  • Shift from control to eradication approach.
• Impact:
  • Prevalence reduced from 57.2 (1981) → 2.4 (2004) per 10,000.
  • Grade II deformities declined from 20% (1981) → 1.5% (2004).
• World Bank projects (1993–2004):
  • Funded community participation and IEC innovations.
  • Focus on women, tribals, urban poor.
• 2005: India achieved elimination as a public health problem nationally (<1/10,000 prevalence).

Phase III: Sustaining Elimination (2005–Present)

Core Strategies under NLEP

• Free diagnosis and MDT for all cases.
• Post-Exposure Prophylaxis (PEP): Single dose rifampicin (SDR) for contacts of leprosy patients.
• Early Case Detection Campaigns (ECDC):
  • Leprosy Case Detection Campaign (LCDC) – Door-to-door surveys.
  • Focused Leprosy Campaigns – Targeted surveillance in affected clusters.
  • ABSULS – ASHA-Based Surveillance for Leprosy Suspects (grassroots detection).
• Disability Prevention and Medical Rehabilitation (DPMR):
  • Distribution of MCR footwear, Self-care kits, aids and appliances, ₹12,000 compensation for reconstructive surgery-related wage loss.
• Community Awareness:
  • Sparsh Leprosy Awareness Campaign on Anti-Leprosy Day.
• Digitalization:
  • Nikusth 2.0 (2023): ICT-based portal for patient tracking and drug logistics.
• Anti-Discrimination Drive:
  • States encouraged to repeal discriminatory laws against leprosy.

Institutional and Legal Strengthening

• Integration with NHM: Centrally sponsored scheme under National Health Mission.
• Inclusion in national health platforms:
  • Screening integrated with Ayushman Bharat (30+ years), RBSK, and RKSK.
• AMR Surveillance:
  • National Anti-Microbial Resistance Surveillance for Leprosy launched in 2023.
• Mental Health Integration:
  • National Framework for Integration of Mental Health Services for Leprosy Patients (2023).
• Revised Treatment Regimen (2025):
  • Triple-drug therapy standardized for both PB & MB cases.
• Focus on PVTGs:
  • Nikusth 2.0 tagging for PVTGs across 17 States under PM-JANMAN.

Quantitative Outcomes (As of 2025)

•  
• Top endemic states: Chhattisgarh (1.80), Jharkhand (1.46), Odisha (1.37), Maharashtra (1.12).
• Lowest prevalence: Meghalaya (0.03), Manipur (0.05), J&K (0.07).

National Strategic Plan & Roadmap (2023–2027)

• Aligned with: WHO Global Leprosy Strategy 2021–2030 & WHO NTD Roadmap 2021–2030.
• Goal: Interrupt transmission by 2027 and achieve zero indigenous cases by 2030.
• Strategic Pillars:
  • Accelerated case detection (targeted approach).
  • Intensified surveillance and digitalization (Nikusth 2.0).
  • Chemoprophylaxis for all contacts.
  • Vaccine introduction (under evaluation).
  • Anti-microbial resistance & adverse drug monitoring.
  • Post-treatment surveillance & integrated rehabilitation.
  • Behavioural change communication (BCC) to eliminate stigma.
  • Repeal discriminatory laws.
  • Multi-disease service integration and retention of leprosy expertise.

International Cooperation

• WHO:
  • Free MDT drug supply, technical guidance, evaluation, and training.
  • Supported MLECs, COMBI (Bihar), and surveillance.
• World Bank: Funded community-oriented projects (1993–2004).
• ILEP, GPZL, Sasakawa Health Foundation, ALERT India, Schieffelin Institute, Hind Kusht Nivaran Sangh:
  • Strengthened IEC, rehabilitation, and advocacy against stigma.
• Global Recognition:
  • WHO dropped India (2006) from the list of non-eliminated countries.
  • India featured in The Global Appeal annually since 2006.

Key Challenges

• Residual endemic pockets in Chhattisgarh, Jharkhand, Maharashtra, Odisha.
• Persistent social stigma and legal discrimination in some states.
• Post-COVID disruption to active case detection and surveillance.
• Need for new diagnostics and vaccine development.
• Underreporting due to stigma and private sector data gaps.

Way Forward

• Whole-of-government and whole-of-society approach integrating NHM, AYUSH, and social justice mechanisms.
• Sustain early detection through ASHA and digital surveillance tools.
• Enhance rehab and mental health support for affected persons.
• Focus on zero child cases for five consecutive years as proof of interrupted transmission.
• Policy integration: NLEP to merge with broader Neglected Tropical Diseases (NTDs) platform.
• Continued international partnerships for research and innovation.

Conclusion

• India’s leprosy control is a global public health success, reflecting:
  • 99% drop in prevalence (1981–2025).
  • 98% decline in patients under treatment.
• From stigma to integration: India’s journey aligns medical success with social justice.
• However, elimination ≠ eradication — vigilance must continue.
• With political will, digital innovation (Nikusth 2.0), community participation, and global collaboration, India is poised to achieve zero transmission by 2030, marking a historic humanitarian milestone in global disease elimination.

ICG conducts 10th NATPOLREX-X & 27th NOSDCP off Chennai Coast

Why in News

• Indian Coast Guard (ICG) conducted 10th National Level Pollution Response Exercise (NATPOLREX-X) and 27th National Oil Spill Disaster Contingency Plan (NOSDCP) meeting off Chennai coast on October 5–6, 2025.
• 40 foreign observers from 32 countries and 105 national delegates participated.
• Aimed to test and strengthen national preparedness and inter-agency coordination for marine oil spill response.

Relevance

• GS-3 (Environment & Disaster Management): Marine pollution control, NOSDCP framework, coastal resilience, SDG-14, Blue Economy.
• GS-2 (Governance & IR): Inter-agency coordination, institutional roles (ICG, ministries), international maritime cooperation.

Background & Institutional Context

• Indian Coast Guard (ICG) is the Central Coordinating Authority for oil spill response since March 1986.
• NOSDCP (National Oil Spill Disaster Contingency Plan):
  • Drafted by ICG and approved in 1993.
  • Provides a national framework for preparedness and response to oil spills.
  • Supported by four Pollution Response (PR) Centres:
    • Mumbai, Chennai, Port Blair, Vadinar (Gujarat).
• NATPOLREX is a biennial flagship exercise under NOSDCP.
  • Tests operational readiness, equipment efficacy, and joint coordination among agencies.

Objectives of NATPOLREX-X

• Assess national capability to detect, contain, and clean up oil spills.
• Evaluate coordination between ICG, central ministries, coastal states, and ports.
• Validate communication, logistics, and decision-making protocols.
• Strengthen international collaboration and knowledge sharing in marine environmental protection.

Key Highlights of NATPOLREX-X (2025 Edition)

• First-ever shoreline clean-up drill at Marina Beach, Chennai.
  • Conducted by Greater Chennai Corporation, Tamil Nadu Pollution Control Board, State Disaster Management Authority, Police, and other state agencies.
• ICG Asset Deployment:
  • Pollution Control Vessels (PCVs)
  • Offshore Patrol Vessels (OPVs)
  • Fast Patrol Vessels (FPVs)
  • Chetak helicopters and Dornier aircraft for aerial surveillance and dispersant spraying.
• Supervision:
  • Exercise overseen by DG Paramesh Sivamani, Director General, ICG & Chairperson, NOSDCP.
  • Reviewed response coordination, operational efficiency, and inter-agency synergy.

Technical Sessions – Contemporary Focus Areas

• Nurdle Spills and their Environmental Impact: Microplastic pollution from plastic pellets.
• Case Studies on Hazardous & Noxious Substances (HNS).
• Post-Spill Monitoring & Environmental Impact Assessments (EIA).
• Shoreline Cleanup Lessons from MV MSC ELSA 3 Incident.
• Provided a platform for scientists, policymakers, and experts to exchange best practices and recovery strategies.

National and International Participation

• Attended by:
  • Central ministries, Coastal State Governments, Major Ports, Oil Handling Agencies, Maritime Organizations, and Foreign Observers.
• 32 countries represented — enhancing global cooperation in marine spill management.
• Reinforced India’s regional leadership role in the Indian Ocean Region (IOR) for maritime environmental protection.

Strategic and Policy Significance

• India imports over 75% of its crude oil by sea → oil spill preparedness is strategically critical.
• Exercise enhances energy security resilience and environmental safety.
• Aligns with PM Modi’s Aatmanirbhar Bharat vision:
  • Showcased indigenous pollution response technology and Make in India maritime assets.
  • Encouraged self-reliance in environmental response systems.

Broader Environmental and Governance Linkages

• Supports Sustainable Development Goal (SDG) 14 – Life Below Water.
• Integrates with Blue Economy framework through marine pollution control.
• Promotes inter-agency collaboration among:
  • ICG, MoEFCC, MoPNG, Shipping Ministry, and Coastal States.
• Enhances marine biodiversity protection and resilience of coastal ecosystems.

Outcome and Way Forward

• Validated the multi-layered pollution response mechanism of the ICG.
• Improved response coordination protocols across agencies and ports.
• Strengthened international engagement for capacity building in the Indian Ocean Region.
• Will feed into updating the NOSDCP 2026–2030 roadmap, incorporating:
  • New technologies (AI-based surveillance, satellite mapping).
  • Local community participation in shoreline response.

Conclusion

• NATPOLREX-X (2025) marks a milestone in India’s marine environmental governance.
• Reinforces India’s commitment to clean oceans, climate resilience, and maritime sustainability.
• Positions ICG as a regional hub for pollution response expertise under the broader Indo-Pacific cooperation framework.