Hansen’s disease (leprosy) as a ‘skin-related neglected tropical disease (skin NTD)’: Future directions

<p>  In June 2022, the World Health Organization (WHO) released ‘A Strategic Framework for Integrated Control and Management of Skin NTDs’. Skin NTDs, or ‘skin-related neglected tropical diseases’ are a subgroup of NTDs that were created with the aim of integrating NTDs with skin manifestations into comprehensive disease control efforts. More than half of the diseases or disease groups identified by WHO as NTDs fall under this subgroup. Unlike NTDs that are addressed through mass drug administration (MDA), the approach for most skin NTDs, including Hansen’s disease (leprosy), has historically been resource-intensive due to the need for individualized diagnosis and treatment. Consequently, they received less attention from public health initiatives as compared to NTDs targeted by MDAs. With integration, it is expected that the efforts will enhance the efficiency and effectiveness of disease control measures for skin NTDs. Besides Hansen’s disease, skin NTDs include diseases such as Buruli ulcer, cutaneous leishmaniasis, lymphatic filariasis, mycetoma, onchocerciasis, scabies, and yaws. </p><p>  The strategic framework outlines 20 cross-cutting areas in which skin NTDs can collaborate, including awareness-raising, early detection and surveillance, diagnosis, wound care, rehabilitation, and surgery. Notably, Hansen’s disease is the only disease linked to all 20 areas. With a wealth of experience already accumulated in each of these areas for Hansen’s disease, this field is well positioned to take the lead in this new movement as a role model for other skin NTDs, particularly for stigma and discrimination reduction. </p><p>  However, not all aspects could be or should be integrated, as certain diseases require specific expertise that must be retained. For example, in the case of Hansen’s disease, expertise in treating leprosy reactions should not be diminished by the shift towards integration. This article provides an overview of the strategic framework, featuring specific examples, and explores the future directions of Hansen’s disease within the evolving landscape of disease control initiatives.</p>