| Summary: | Aparna Pandey All India Institute of Hygiene and Public Health, Kolkata, India Abstract: This review examines trends of new leprosy cases during the post elimination phase in India and its provinces, mainly on the basis of data from the Central Leprosy Division of the National Leprosy Eradication Programme, to highlight that leprosy remains a challenge to health care providers. Critical issues and challenges related to active transmission of the disease resulting from hidden cases and delayed detection and initiation of treatment are discussed. Suggestive indicators, eg, fluctuating annual new case detection rates, a persistently high proportion of children in new detected cases (9%–11%), and an increase in the proportion of new cases with deformity (from 1.6%–4.1%) are described. Certain program-related issues and changing strategies are also addressed. Evolution of the program over the years and integration of the National Leprosy Eradication Programme into the general health system and its impact are also analyzed. The impending threat of complacency and potential loss of our hard-earned success thus far are discussed, along with the impact of the stigma associated with leprosy on both the individual and the community. To deal with the disease effectively, we need to face the hidden challenge of undiagnosed cases, halt ongoing transmission, achieve better epidemiological control by effective monitoring, enhance skills at all levels, and promote community involvement by educational interventions which are culturally acceptable and scientifically sound. Keywords: leprosy, integration, public health challenge, new case detection
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