In a country once believed to be long past leprosy, new figures paint a troubling picture about the disease.
For example, Mchinji District Health Office (DHO) has recorded 11 new cases of leprosy in 2025 alone, raising an alarm among health authorities and communities alike.
According to Mchinji DHO public relations officer Owen Chataika, the district is still registering new leprosy cases.
“This year some new cases that have already been registered, which is something worrying,” said Chataika.
Caused by a bacterium called Mycobacterium leprae, leprosy, also known as Hansen’s disease, is a chronic infectious disease.
Although it can influence the mucous membranes and other regions of the body, its primary effects are on the skin and peripheral nerves.
Leprosy is a treatable condition that can be cured with antibiotics, even though it can result in nerve damage and deformity.
Leprosy was officially declared eliminated in Malawi in 1994, after recording fewer than one per 10 000 people.
But despite the milestone, the disease has never fully disappeared.
Today, three districts of Balaka, Nkhotakota, and Mchinji continue to register more than one case per 10 000 people, breaching the elimination threshold.
“It is a cause for us to worry because even though we reached the elimination level in 1994, there are still some districts that are reporting more than one leprosy case per 10 000 people,” said Dickens Chimatiro, monitoring and evaluation officer for the National Tuberculosis and Leprosy Elimination Programme (Ntlep).
“This means that we still have this burden in those districts. So it is a cause for worry, and that calls for concerted efforts to reduce the burden,” he added.
In Mchinji, health officials are grappling with the unexpected spike, and it is a situation that cannot be ignored.
“For us to have already registered 11 new cases this year is worrisome,” Chataika said. “It shows that leprosy is still a hidden problem in our communities.”
Mchinji district’s situation is fuelled by challenges that the DHO is facing.
Some patients travel long distances to access health services at the district hospital; there is inadequate funds for conducting contact tracing; no more mobile clinics and community sensitisation due to Usaid aid cut; few trained health workers on leprosy management; and the majority of communities are not aware of this disease.
“As a way forward, the district health office plans to decentralise leprosy clinics and also lobby for more funds for mobile clinics, contact tracing and community sensitisation,” said Chataika.
At the national level, Ntlep acknowledges the setbacks.
“Currently, Malawi has more than 600 people undergoing treatment for leprosy, and in terms of new cases, as of 2024, we have registered 367,” said Chimatiro.
According to the World Health Organisation (WHO), the disease is believed to be transmitted through droplets from the nose and mouth of an untreated case of leprosy, containing the causative agent, following prolonged, close contact.
The disease does not spread through casual contact like shaking hands or hugging, sharing meals or sitting next to each other.
The patient stops transmitting the disease upon initiation of treatment.
Eliminating the condition does not necessarily mean that it is completely gone, so a few cases can be found, but they must be at acceptable levels as defined by the prevalence of less than one per 10 000 population as per World Health Assembly resolution 44.9.
Health issues commentator Maziko Matemba believes that as a country, Malawi should ponder why there is resurgence of the disease after a very long time.
According to Matemba, as the country looks at what has gone wrong, there is need to, also, learn from what was done before in getting the elimination status of the condition.
“Factors contributing to the resurgence can be many. I think one thing that can be pointed out is surveillance and prevention, because normally when we say we have eliminated a disease, we also must have strong systems which can control the recurrence of the condition.
“What do we do? And also, how do we make sure that the disease does not come back? We have to check our systems to see what has gone wrong, though there can be many factors, including financing programmes for leprosy,” Matemba said.
Even as Malawi continues to celebrate decades of progress, the recent surge of cases in districts like Mchinji, Nkhotakota and Balaka underscores a sobering reality.
The battle against leprosy may have been declared won, but it is far from over, and there is no need to relax.
