Leprosy Mission Southern Africa

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TB Mortality Rates Dropping in Africa – but There’s Still Work to be Done

tuberculosis

According to the WHO’s Global TB Report 2024, the African region has achieved a dramatic 42% reduction in tuberculosis (TB) deaths and a 24% drop in TB cases between 2015 and 2023.1,2

 Read the full report here.

South Africa has led the way in TB control measures, becoming the first country in Africa to achieve a 50% reduction in the disease ahead of the WHO’s schedule. Mozambique, Tanzania, Togo, and Zambia have reduced TB deaths by 75%, meeting the goal of the WHO End TB Strategy.1,2

While this is encouraging news, there are still some major challenges ahead when it comes to eradicating TB – and the related disease of leprosy – in the African region. 

 

The Relationship Between TB and Leprosy

While leprosy and TB are two distinct diseases, they are related in several ways:3,4
  • Both conditions are chronic granulomatous infections caused by mycobacteria (Mycobacterium leprae and Mycobacterium tuberculosis).
  • They are both transmitted via air droplets.
  • A weakened immune system is a risk factor for both diseases.
  • The clinical presentations, including skin and nerve symptoms, can overlap. For example, leprosy can cause skin lesions similar to those caused by cutaneous TB.
  • Both diseases are more prevalent in developing countries. 
  • Both can be associated with social and environmental factors like poverty and poor healthcare access.
 
Africa has seen encouraging news in the field of leprosy as well as TB. Leprosy elimination (a prevalence rate of less than 1 per 10,000 people) has been achieved at the regional level and in almost all the Member States of the WHO African region. However, both TB and leprosy still present significant challenges in Africa.1,5,6

TB Challenges

Diagnosing and treating multidrug-resistant TB strains and addressing the substantial economic burden on affected households are key challenges in the African region.1

 African patients have limited access to rapid diagnostics, which currently reach only around half (54%) of TB patients. (The good news is that this number has more than doubled since 2015, when it was just 24%.)1

 Not only that, but TB also has a profound economic impact in Africa, with 68% of affected households facing life-altering treatment costs. The African region requires $4.5 billion in funding annually for comprehensive TB services, but only $0.9 billion is currently available, leaving a substantial funding gap of $3.6 billion.1

Leprosy Challenges

The leprosy burden and specific disease hotspots remain in numerous African countries, with more than 20,000 new cases reported every year despite the disease’s elimination status.6

 Healthcare workers lack training in how to recognise leprosy, and so many cases still go undiagnosed or receive a late diagnosis once the disease has become very advanced.7

 While leprosy medication is provided for free, many patients face significant financial burdens during leprosy treatment – such as high travel costs in order to get to the clinics where they receive their medication. Treatment for the complications of leprosy can also be expensive, and disabilities or discrimination resulting from leprosy can cost patients their income.8

 Some patients stop taking their medication before completing the full course, which means their leprosy will not be cured and can still cause symptoms or be spread to others. A recent study showed that, while 99.5% of leprosy patients received multi-drug therapy (MDT), 27% of these patients failed to complete their treatment, contributing to a substantial public health challenge.9

A Renewed Commitment to Fighting NTDs Like Leprosy in Africa

Gathering in Togo this April for the NTD Programme Managers meeting, African health experts agreed to accelerate efforts to end NTDs, which continue to affect over one billion people globally, 40% of whom live in Africa.10

 The African region is home to twenty of the 21 recognised neglected tropical diseases (NTDs) in the world, including leprosy. Despite the progress made in recent years, all 47 countries in the WHO African region are still endemic for at least one NTD, and 37 of these countries are battling five or more NTDs simultaneously.10

 The WHO is working closely with member states and partners to adapt public health strategies, enhance disease surveillance, and ensure timely responses to the evolving challenges presented by NTDs.10

 Please join us in praying for these leaders as they work to fight the burden of NTDs. 

The Leprosy Mission's Role

Organisations like The Leprosy Mission work to treat leprosy patients, educate communities and health workers about leprosy, and fight the stigma attached to the disease. 

Our initiatives and support complement broader national efforts to combat TB and other infectious diseases. For example, The Leprosy Mission Nigeria (TLMN) is actively involved in supporting national TB control programmes, including through the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP).11

To learn more about leprosy and how to help those affected by it, visit The Leprosy Mission Southern Africa or follow our Facebook page for regular news about our work. 

 

References: 

1. African region sees significant decline in TB mortality, WHO reveals. DG Alerts. Accessed April 22, 2025. https://dgalerts.docguide.com/article/african-region-sees-significant-decline-in-tb-mortality-who-reveals.

2. Global Tuberculosis Report 2024. World Health Organization. Accessed April 22, 2025. https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2024.

3. Rakotoarisaona MF, Razafimaharo TI, Sendrasoa FA, et al. Coinfection with leprosy and tuberculosis: a case series in Malagasy patients. IDR. 2024;17:1507-1513. doi:10.2147/IDR.S458888.

4. Keragala BSDP, Herath HMMTB, Janapriya GHDC, et al. Coexistence of mycobacterial infections – Mycobacterium tuberculosis and Mycobacterium leprae – in Sri Lanka: a case series. Journal of Medical Case Reports. 2020;14(1):101. doi:10.1186/s13256-020-02413-w.

5. Yoganathan V. Leprosy persists in South Africa despite “elimination” status – 20-year study. Juta MedicalBrief. Accessed April 22, 2025. https://www.medicalbrief.co.za/leprosy-persists-in-south-africa-despite-elimination-status-20-year-study/.

6. Leprosy. World Health Organization Regional Office for Africa. Accessed April 22, 2025. https://www.afro.who.int/health-topics/leprosy.

7. Abeje T, Negera E, Kebede E, et al. Performance of general health workers in leprosy control activities at public health facilities in Amhara and Oromia States, Ethiopia. BMC Health Serv Res. 2016;16:122. doi:10.1186/s12913-016-1329-2.

8. New study reveals crippling financial burden of leprosy. London School of Hygiene and Tropical Medicine. Accessed April 22, 2025. https://www.lshtm.ac.uk/newsevents/news/2015/financial_burden_leprosy.html.

9. Sons JS, Mkhize ZN, Dlova NC, et al. Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study. S Afr Med J. Published online May 9, 2024:e1630. doi:10.7196/SAMJ.2024.v114i5.1630.

10. African health experts commit to accelerate efforts to eliminate neglected tropical diseases. World Health Organization Regional Office for Africa. Accessed April 22, 2025. https://www.afro.who.int/countries/togo/news/african-health-experts-commit-accelerate-efforts-eliminate-neglected-tropical-diseases.

 

11. NTBLCP. National Tuberculosis & Leprosy Control Programme. Infolep. Accessed April 22, 2025. https://www.leprosy-information.org/organization/ntblcp-national-tuberculosis-leprosy-control-programme.