Influenza

Globally, influenza detections remained low in week 36 with influenza A viruses detections predominant.

In the southern hemisphere, influenza percent positivity was elevated (>10%) in some countries in Temperate South America and in single countries in Tropical South America and Eastern Africa. Percent positivity was over 30% in one country in Oceania where a small increase in activity was observed. A small increase in activity was also reported in a single country in Temperate South America.

In the northern hemisphere, influenza percent positivity was elevated (>10%) in some countries in Central America and the Caribbean, Western Africa, Western, Southern, South-East and Eastern Asia, and in single countries in Tropical South America and Middle and Eastern Africa. Percent positivity was over 30% in some countries in Western Africa and Southern Asia and in a single country in South-East Asia. Increases in activity were observed in some countries in Western, Southern and South-East Asia and in single countries in Central America and the Caribbean, Northern Europe, Western and Eastern Africa, and Eastern Asia.

In the zones with elevated positivity, influenza A(H3N2) was predominant in Western Africa, Eastern Asia and Oceania; influenza A(H1N1)pdm09 was predominant in Eastern Africa, Western, Southern and South-East Asia and influenza B was predominant in Temperate South America. Influenza A and B were codominant in Central America and the Caribbean and Tropical South America.

SARS-CoV-2

Globally, SARS-CoV-2 positivity remained stable and low across most reporting countries, with elevated positivity (>10%) reported in some countries in Central America and the Caribbean, Northern and South West Europe and Eastern Asia, and in single countries in Tropical South America and Western, Southern and Eastern Asia. Small increases in activity were observed in countries in Northern Europe, and in single countries in Tropical South America, South West Europe and Western, South-East and Eastern Asia.

Respiratory Syncytial Virus (RSV)

RSV positivity was elevated (>10%) in a few countries in Central America and the Caribbean and Temperate South America and in single countries in Western Africa and Southern Asia. Percent positivity was over 30% in a single country in Temperate South America. Increases in activity were observed in single countries in Central America and the Caribbean, Western Africa and Southern Asia. RSV and influenza activity were both elevated in countries in Temperate South America, Western Africa and Southern Asia.

Severity Assessment

The severity assessments here are reported from countries, areas and territories. Assessments for transmissibility can be reported based on syndromic parameters and/or influenza-specific parameters. In the southern hemisphere temperate and subtropical areas, influenza-specific transmissibility was reported as low in a single country; transmissibility using syndromic data was reported as below seasonal threshold in a single country. In the northern hemisphere temperate and subtropical areas, influenza-specific transmissibility was reported as below seasonal threshold in 14 countries, and low and moderate in single countries; transmissibility using syndromic data was reported as below seasonal threshold in nine countries. Influenza-specific transmissibility was reported as below seasonal threshold in a single country in the tropical areas.

WHO collects epidemiological and programmatic data from countries annually, through a customized DHIS2 application, to compile and update on the global leprosy situation.

For this update, reporting was done for the calendar year 2025, although a few countries reported for a different 12-month period (e.g. India reported for April 2025-March 2026 and Canada for the calendar year 2024). Epidemiological indicators have been expressed as absolute numbers, proportions, and rates. Rates were calculated per million population (total and child). Population estimates (medium variant) were accessed from the United Nations Department of Economic and Social Affairs, World Population Prospects 2024³.

Data on leprosy for 2025 was received from 203 countries and territories in all six WHO Regions. The number of countries that provide information on leprosy has increased significantly over the years. The regional distribution of countries and territories that reported data for 2025 was as follows: 47 in the African Region (AFR), 45 in the Region of the Americas (AMR), 19 in the Eastern Mediterranean Region (EMR), 46 in the European Region (EUR)⁴, 10 in the South-East Asia Region (SEAR)⁵ and 36 in the Western Pacific Region (WPR). All countries in the AFR and SEAR provided reports; the reports from AMR, EUR and WPR increased as compared to the previous year. Reports were received from all 23 global priority countries for leprosy.

The number of new cases and the corresponding rates, disaggregated by age, of cases among women and of new cases with grade-2 disability (G2D) are presented by WHO Region in Table 1.

During 2025, a total of 167 356 new cases were reported globally, corresponding to a new case detection rate of 20.3 per million population. The number was 3.1% lower than in 2024 (172 717). New cases were reported from all the six WHO Regions (Figure 2). SEAR accounted for 60.2%, followed by AMR (14.6%), AFR (11.7%), WPR (11.7%), EMR (1.8%) and EUR (<1%). The change in new case detection as compared to the previous year varied across regions: EMR and EUR reported increases of 23.7% and 19.6% respectively, AFR and AMR also reported increases, albeit modest of 2.2% and 3.4%. SEAR reported a decline of 18.9% while WPR recorded a significant increase, reflecting Indonesia’s shift from SEAR to WPR during 2025⁵. Decadal trends in new case detection by WHO Region, between 2016 and 2025, are shown in Figure 3. The global new case detection has decreased by 23.3% compared with 2016.

Figure 2: Detection of new leprosy cases, by WHO Region, 2025

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Figure 2: Detection of new leprosy cases, by WHO Region, 2025

AFR = African Region; AMR = Region of the Americas; EMR = Eastern Mediterranean Region; EUR = European Region; SEAR = South-East Asia Region; WPR = Western Pacific Region

The 23 global priority countries for leprosy accounted for 95.6% (160 042) of all new cases detected in 2025. During the last decade, >95% of global new cases have remained clustered in these countries (Table 2). The global priority countries reported an overall 3.3% decrease in number of new cases detected as compared to the previous year, though this varied across individual countries. A decrease was observed in 12 global priority countries, ranging from 27.7% in Comoros to 0.4% in Democratic Republic of Congo. In 10 global priority countries, more new cases were detected than in the previous year, Sudan reporting a significant increase (170.5%), followed by Nigeria (40.2%) and Egypt (23.6%). Sri Lanka reported the same number of new cases as in the previous year.

Figure 3: Trends in new leprosy case detection with corresponding new case detection rates, by WHO Region, 2016-2025

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Figure 3: Trends in new leprosy case detection with corresponding new case detection rates, by WHO Region, 2016-2025

AFR = African Region; AMR = Region of the Americas; EMR = Eastern Mediterranean Region; EUR = European Region; SEAR = South-East Asia Region; WPR = Western Pacific Region

During the year, 62 countries reported zero new cases (in addition, Switzerland reported “no data available”), 53 reported 1-10 new cases, 42 reported 11-100 new cases, 30 reported 101-1000 new cases, and 12 countries reported 1001-10 000 new cases. Brazil, India and Indonesia reported more than 10 000 new cases each, together accounting for 78.3% of all new cases reported. While Brazil and Indonesia reported increase in new cases in 2025 as compared to the previous year (3.5% and 10.8% respectively), a decrease in new case detection was reported by India (9.1%).

The occurrence of new leprosy cases among children (aged <15 years) is an indicator of recent transmission. A total of 8344 new child cases (5% of total new cases) were reported globally, with a corresponding rate of 4.2 per million child population. Most of the child cases were reported by SEAR (51.4%) with a child case detection rate of 9.6 per million child population. In the global priority countries, the proportion of new cases among children ranged from 2.5% in Sudan to 30% in Comoros. No child case was reported from 123 countries: 15 in AFR, 30 in AMR, 12 in EMR, 43 in EUR, 3 in SEAR and 20 in WPR.

Data disaggregated by age were available for 2158 cases in children, reported by 65 countries (including 14 global priority countries). Of these, 75.5% were among children aged 10-14 years, 20.7% in the age group of 5-9 years and 3.8% among those aged <5 years.

The trend in the number of new child cases and the rate per million child population by WHO Regions during 2016 and 2025 are shown in Table 3. Analysis of the trend shows a 55.8% decrease in the child case detection rate, from 9.5 in 2016 to 4.2 per million child population in 2025.

New cases with visible impairments or Grade 2 disability (G2D) indicate delayed case detection. Globally, 9428 new cases with G2D were detected (corresponding to a G2D rate of 1.1 per million population), accounting for 5.6% of all new cases detected during the year. Of the new G2D cases, 29.2% were reported from AFR, followed by AMR (27.9%) and SEAR (27.4%); the remaining cases were reported from other regions. The global priority countries accounted for 86.8% (8184) of all new G2D cases. Table 4 shows the trends in G2D in new cases during the past 10 years (2016-2025) by WHO Region.

The number of new G2D cases increased by 3.3% as compared to the previous year (9124). There has been a 27.8% decrease in G2D as compared to 2016; SEAR reported a significant decrease in new G2D cases (65.8%) during this period.

Disabilities among new child leprosy cases signal delayed detection and ongoing transmission. In 2025, 284 new child cases with G2D were reported across 33 countries, up from 256 the previous year, with most cases in AFR (162), SEAR (48), AMR (34), WPR (34), and EMR (6).

Country-wise data on prevalence, new case detection, re-treatment, relapse, treatment completion are presented in Table 5. The table also informs number of non-autochthonous cases registered by country.

Globally, 65 013 cases of leprosy were reported among women, comprising 38.8% of all new cases detected. In the global priority countries, the proportion ranged from 17.8% in Madagascar to 61.8% in Ethiopia. These differences highlight the need for approaches that respond to gender-specific barriers to diagnosis and care.

New cases of multibacillary (MB) leprosy comprised 73.2% (122 531) of all new cases detected in 2025. In the global priority countries, Egypt, Indonesia, Madagascar, Nigeria, the Philippines, South Sudan and Sudan reported more than 90% MB among their total new cases detected. The high proportion of MB cases highlights the need for continued attention to timely diagnosis and appropriate classification.

A total of 1095 non-autochthonous cases were reported by 57 countries. Among the new cases reported by EUR, 83.7% were non-autochthonous. All detected cases were reported as non-autochthonous in 25 countries or territories: Brunei Darussalam, Chile, Cook Islands, Croatia, Curaçao, Denmark, Finland, France, Germany, Japan, Kuwait, Malta, Mauritius, Netherlands, Oman, Portugal, Qatar, Republic of Korea, Réunion, Romania, Saint Lucia, Saudi Arabia, Spain, Sweden and United Kingdom.

Data on treatment completion rates for cases of MB and of paucibacillary (PB) were available from 93 and 79 countries, respectively. The rates of treatment completion varied widely among global priority countries; a sub-optimal rate (<85%) was reported by 11 countries for MB and 6 countries for PB.

A total of 5339 cases (4739 MB and 600 PB) were reported as lost to follow up during the reporting year. Monitoring treatment completion is an important programmatic need, while context-specific strategies at the patient level are required to improve adherence to MDT.

Periodic nerve function assessment is essential to care and support. Of the 38 254 cases assessed at treatment completion, 1323 (3.5%) showed deterioration in nerve function or disability status, highlighting the need for closer monitoring and timely intervention. This also reinforces the need for person-centered care beyond completion of MDT.

Provision of disability care services was reported by 65 countries, including 13 global priority countries. A total of 2673 reconstructive surgeries were performed during the year.

Lepra reactions were reported by 75 countries. A total of 14 890 cases were diagnosed as type-1 reaction and 7557 as type-2 reaction.

A total of 13 029 re-treatment cases were reported: Brazil, India and Indonesia accounting for 77.8% of these cases. Relapse comprised 31.4% (4096 cases) of all cases of re-treatment cases. Of the 77 countries that reported relapses, Brazil, India, Ethiopia and Angola accounted for 80.2% of cases.

Laws that allow discrimination on the basis of leprosy were reported by 11 countries as still existing. Work is in progress in countries for repealing these laws.

As part of active case finding efforts, 92 countries, including 19 global priority countries, reported data on contact screening, leading to the identification of 8332 new cases. Of these, 68 countries or territories, including 17 global priority countries or territories (Angola, Bangladesh, Comoros, Côte d’Ivoire, Democratic Republic of Congo, Egypt, Ethiopia, India, Indonesia, Kiribati, Myanmar, Nepal, Nigeria, South Sudan, Sri Lanka, Sudan and United Republic of Tanzania) combined contact screening with post-exposure prophylaxis (PEP). This represents an increase in the number of countries offering this intervention compared to the previous year, with country reports indicating both the feasibility and acceptability of these approaches.

Robust pharmacovigilance is essential for the early detection and management of adverse drug reactions. In this regard, 32 countries reported a total of 350 adverse drug reactions (ADRs), of which 327 were attributed to dapsone.

On antimicrobial resistance surveillance, data were received from 25 countries, more countries compared to previous years, including six global priority countries: Bangladesh, Brazil, Kiribati, Madagascar, Micronesia (Federated States of) and Nepal. A total of 865 new and 1160 retreatment cases (2025 cases) were tested, of which the results showed resistance to rifampicin (all retreatment) in 3, to dapsone in 11 (7 retreatment and 4 new cases), and to both rifampicin and dapsone in 28 (27 retreatment and 1 new case). Strengthening of antimicrobial resistance surveillance in leprosy remains essential and is encouraged across countries.

Editorial

The year 2025 marks the midway point of the Global Leprosy Strategy 2021–2030. At this juncture, it is worth assessing not only the progress in new case detection, but whether a person-centered approach has remained central to the interventions. Strengthening this approach is integral to achieving and sustaining elimination, ensuring that people affected by leprosy receive timely, accessible and comprehensive care and support and are meaningfully engaged as partners in the elimination effort.

This year, Chile became the latest country to be verified and acknowledged by WHO for elimination of leprosy disease, joining Jordan in the post-elimination phase. Each verification is a reminder that elimination is never purely an epidemiological milestone: it reflects sustained political commitment, a responsive health system providing continuity of care and support, and an enabling environment. The Leprosy Elimination Framework and its accompanying tools, LEMT and LPTA, are what makes this verifiable and consistent across different national contexts. It is notable that Chile has maintained robust surveillance and continues to detect and report non-autochthonous cases as per WHO post-elimination surveillance guidelines.

Early detection and prompt treatment with MDT have been the cornerstone for leprosy elimination. This year’s increase in new disability cases, particularly among children, is of concern and highlights the urgent need to prioritize early detection.

Contact screening along with single-dose rifampicin post-exposure prophylaxis (SDR-PEP) is a tool for early case detection and prevention among contacts, also providing opportunities for capacity building of health-care staff and awareness generation at community level.

Keeping clinical expertise alive and referral pathways intact so that disability and lepra reactions continue to be managed promptly, is a measure of person-centered care and integral to approaches for new case detection.

The insights from the reports on antimicrobial resistance surveillance in leprosy reinforces the need for further strengthening and expansion. Sustained investment in laboratory capacity, standardized testing, and timely reporting will ensure countries can respond effectively.

None of these interventions work as a one-size-fits-all model. Women and children affected by leprosy face distinct challenges of stigma and barriers to diagnosis and treatment and therefore require strategies that respond to their specific needs.

Meaningful engagement of organizations of people affected by leprosy is not merely a component of elimination; it is the foundation on which it rests. Sustained, structured participation with people affected by leprosy recognized as essential partners, not passive beneficiaries, is what a person-centered approach requires.

This year, the Sasakawa Health Foundation reiterated its long-standing support to global leprosy efforts through WHO, and Novartis signed a memorandum of understanding renewing its supply of MDT and SDR-PEP for a further five years. Indeed, elimination of leprosy is a shared goal and a shared responsibility, one that requires national programmes, WHO, donors, civil society and, above all, people affected by leprosy to work together.

Elimination must not be misconstrued as an end of efforts. As countries reach elimination, sporadic cases and cases among migrants will continue to be detected, and access to care without stigma must extend into the post-elimination phase as firmly as before.

WHO encourages every country to adopt the Global Leprosy Strategy and adapt its targets and pillars to its own context. At the midpoint of the Strategy, the data in this update show where progress stands. It is worth remembering that behind every number reported here is a person, and every pillar, every tool, and every partnership must continue to place that person at its center.