✍ Contributed by Dr. Venkata Ranganadha Rao Pemmaraju and Yuta Takashima, Sasakawa Leprosy (Hansen’s Disease) Initiative

In July, Indonesia’s first National Leprosy Conference was convened in Jakarta to translate national policy into subnational action, a necessary step considering that provincial and district governments manage key budgets and regulatory instruments. Endorsed by President Prabowo Subianto, the conference brought together ministers, governors, heads of provincial health offices, leprosy supervisors from all 38 provinces, delegations from 12 priority regencies and cities, civil society organizations, implementation partners, and representatives of PerMaTa, an organization of persons affected by leprosy. By mobilizing provincial leaders, strengthening multisectoral coordination, and placing dignity and inclusion for persons affected by leprosy at the center, Indonesia demonstrated renewed national commitment to the leprosy elimination effort.

Leprosy transmission persists despite major gains

Indonesia remains one of the three most leprosy-endemic countries in the world, reporting about 15,000 new cases annually over the past five years. Although the country achieved “elimination of leprosy as a public health problem” as defined by WHO in 2000 and has cured more than one million people through multidrug therapy, continued transmission remains a major concern. In 2024, Indonesia detected 14,698 people with active disease, about 90% of whom had multibacillary leprosy. More than 1,000 children were diagnosed, indicating ongoing transmission in communities. The burden remains concentrated in endemic hotspots – particularly in Papua, West Papua, Gorontalo, North Maluku, Maluku, and North Sulawesi – while several other provinces have reported rising case numbers.

Delayed detection leads to disabilities, which are permanent. Mainly occurring in hands, feet, and eyes, some of the disabilities are visible (grade 2 disabilities), and others are not, but still cause impairment, such as sensory loss. In Indonesia, nearly 900 people were identified with grade 2 disabilities, reflecting gaps in early diagnosis, declining diagnostic capacity among health workers, limited public awareness, and stigma that discourages timely care-seeking.

Sasakawa’s advocacy sparks renewed momentum

The renewed momentum follows sustained advocacy by Yohei Sasakawa, WHO Goodwill Ambassador for Leprosy Elimination. With his encouragement, Indonesia’s Minister of Health advanced targeted plans for high-endemic districts. Joint field visits to high-burden areas helped to reinforce the need for active case finding, stronger local accountability, and campaign-style interventions to reach communities earlier.

National conference aims for action

Discussions focused on early detection and treatment, institutional accountability, and stigma reduction, as well as stronger inclusion of persons affected by leprosy in social protection systems, health insurance, poverty support programs, and civil administrative records. Participants also emphasized the contribution of ministries beyond health in correcting misconceptions, improving awareness, and addressing social barriers that delay diagnosis and treatment.

Plans were announced for the establishment of a National Leprosy Elimination Task Force with five workstreams under a multisectoral approach. The Task Force is expected to bring together ministries responsible for health, education, coordination, religious affairs, and social affairs to integrate medical, social, and economic interventions that support prevention, treatment completion, rehabilitation, and dignity.

The conference also recommended timely access to all levels of health care, a Presidential Instruction on the Acceleration of Leprosy Elimination, and a Ministry of Home Affairs decree directing governors to make the Leprosy Control Programme a local government priority. Recommendations on social inclusion included livelihood support, business start-up assistance, and assistive devices to promote independence among persons with disabilities.

Responding to the joint call of Goodwill Ambassador Sasakawa and the Minister of Health, provincial governors signed a declaration reaffirming their commitment to make leprosy elimination a priority. The declaration commits provinces to equitable access to health services, education, employment, and social services, while promoting inclusive, safe, stigma-free, and discrimination-free communities for persons affected by leprosy and their families.

Indonesia’s renewed push marks a shift from national ambition to provincial accountability. By linking early detection, treatment, social protection, and inclusion, the country is strengthening the foundations for a leprosy-free future in which no person affected by the disease is left behind.