Leprosy elimination

WHO donated MDT

Multidrug therapy (MDT), first recommended by a WHO Expert Committee in 1984, rapidly became the standard treatment of leprosy and has been supplied by WHO free of charge to all endemic countries since 1995.

As a major supplier of very close to 100% of global MDT needs, WHO works closely with donors and manufacturers to plan the manufacture, procurement and shipment of the MDT drugs having the maximum available shelf life, at the time most appropriate for each national programme.

WHO also arranges independent laboratory testing of the drugs at Novartis’ own expense in order to ensure that the finished WHO product is the best available for national programmes. Such testing is considered essential to maintain the confidence of the national programmes in the member states.

WHO starts its supply cycle in August of every year, when it invites all endemic countries to submit their annual official requests. These requests include information on the cuurent registered prevalence, the new case detection during the previous year, and current stock levels of MDT drugs. WHO then estimates the total global requirement of MDT for the following year.

In order to meet emergency requests for MDT, WHO maintains at the donor's own expense, substantial buffer stocks at the manufacturing plant. Currently these buffer stocks are equivalent to around 40% of global annual requirements but are variable, depending on perceived need). In addition, to ensure rapid response times of smaller emergency requests, WHO maintains additional buffer stocks at WHO Geneva and WPRO Manila. Response times from WHO Geneva are typically 48 hours and most despatches are made via courier.

The WHO supply of MDT has been seen to work well by countries, donors and other partners over the years because of the close team work established within WHO (between the Leprosy team, procurement and shipping units), between WHO and Novartis (close collaboration in planning procurement and manufacture, batch testing of drugs, shipping), and the leprosy network established by the Leprosy team with national programmes, WHO country offices and international NGOs.

Main donors of MDT drugs to WHO since 1995