In Malawi, a country once believed to be long past the danger of leprosy, new figures paint a troubling picture.
This year alone, Mchinji District along the border between Malawi and Zambia has recorded 11 new cases of leprosy.
Mchinji District Health Office spokesperson Owen Chataika says the district is still registering new Leprosy cases—raising alarm bells among health authorities and communities alike.
This year, already there are some new cases that have already been registered, which is something worrying,” he says.
Leprosy was officially declared eliminated in Malawi in 1994, with its prevalence below one case per 10 000 people. However, a resurgent wave is underway in three districts—Balaka, Nkhotakota and Mchinji—which have registered more cases.
Caused by mycobacterium leprae, the treatable chronic infectious disease attacks mucous membranes and other body regions, but its primary effects are on the skin and peripheral nerves.
Leprosy, which can be cured with antibiotics, can result in nerve damage and deformity.
“It is a cause for us to worry because even though we reached the elimination level in 1994, there are still other districts that are reporting more than one leprosy case per 10 000 people,” says National Tuberculosis and Leprosy Elimination Programme monitoring and evaluation officer Dickens Chimatiro.
For the government official, this means that the country still has “a cause for worry”, which calls for concerted efforts to make leprosy history.
In Mchinji, health officials are grappling with the unexpected spike.
“The new cases show that leprosy is still a hidden problem in our communities,” Chataika said.
Mchinji district’s situation is partly fuelled by challenges in healthcare provision.
Some patients travel over 15 kilometres to get healthcare at Mchinji District Hospital, but there is inadequate funds for contact tracing, mobile clinics and community sensitisation due to US aid cuts.
There are also few trained health workers to manage leprosy cases and most people remain unaware of the dangers of leprosy, including preventive measures.
“The district health office plans to decentralise leprosy clinics and lobby for more funds for mobile clinics, contact tracing and community sensitisation,” says Chataika.
According to the national programme, more than 600 people in the country are undergoing leprosy treatment.
“Since 2024, we have registered 367 new cases,” says Chimatiro.
According to the World Health Organisation (WHO), the disease is transmitted through prolonged and close contact with droplets from the nose and mouth of an untreated case.
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.
Community health commentator Maziko Matemba says the new cases are food for thought for health authorities.
“As a country, we should ask ourselves why there is a resurgence of the disease after about three decades,” he says.
Matemba says the country should confront what has gone wrong and learn from past strategies that helped eliminate the outbreak.
He states: “Factors contributing to the resurgence can be many, but they could include gaps in disease surveillance and prevention. When we say we have eliminated a disease, we also must have strong systems which control its recurrence.
“We have to check our systems to understand what has gone wrong, including financing for leprosy programmes.
As the country continues to celebrate decades of progress, the recent surge of cases in some districts 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.
