Across islands and communities: accelerating action to interrupt transmission and eliminate leprosy disease in the Pacific

^{The Secretary of Health and officials from the Federated States of Micronesia Department of Health and Social Affairs meet with representatives from the Sasakawa Health Foundation, and the World Health Organization during a consultation visit in Pohnpei to discuss country priorities, implementation challenges and opportunities to strengthen efforts towards interrupting transmission and advancing elimination. Photo Credit WHO/W Shahid}

Majuro, Republic of the Marshall Islands and Pohnpei, Federated States of Micronesia, 02 September 2026:  In a Pacific island community, recognising leprosy early can begin with noticing an unusual skin patch that has lost sensation.

But what happens next is not always simple.

The nearest health worker may be on another island. Transport can depend on boats, fuel and weather. A person may not recognise the early signs or may hesitate to seek care because of fear of stigma or discrimination. And once someone is diagnosed, health teams still need to reach family members and other close contacts who may be at risk.

These practical realities were at the centre of a recent consultation organised by the World Health Organization (WHO), with support from Sasakawa Health Foundation, bringing together health officials and leprosy programme teams from the Federated States of Micronesia (FSM), Kiribati and the Republic of the Marshall Islands (RMI).

Their shared goal is ambitious: moving beyond control towards interruption of transmission and, ultimately, elimination of leprosy disease.

Finding people earlier

Leprosy is curable with multidrug therapy (MDT), and early treatment can help prevent disability. Yet cases continue to occur in parts of the Pacific.

During the consultation in Majuro, participants looked closely at what happens before and after a diagnosis: how people recognise symptoms, where they seek help, whether health workers can identify the disease early, how contacts are screened, and what happens when patients or families live far from regular health services.

The discussions highlighted the need to strengthen early case detection, systematic contact screening and preventive treatment with single-dose rifampicin for eligible contacts, while ensuring continued follow-up and surveillance.

But there was also recognition that the same approach will not work everywhere.

A densely populated community with continued transmission may need intensive contact screening and active case finding. On a small outer island reached only occasionally by health teams, integrating leprosy activities into routine primary health care and outreach may be more practical.

“The tools to interrupt transmission are available, but they must reach the people who need them most,” said Dr Vivek Lal, Team Leader, WHO Global Leprosy Programme. “For Pacific Island countries, success depends on identifying cases earlier, systematically reaching contacts and adapting interventions to local realities. 

Countries also discussed how leprosy services could be integrated more closely with primary health care, tuberculosis, skin health, school health and community outreach, rather than relying on stand-alone systems that place additional demands on already stretched health workers.

^{Representatives from FSM, Kiribati, RMI, WHO and the Sasakawa Health Foundation gather in Majuro, Republic of the Marshall Islands, to exchange experiences, strengthen regional collaboration and identify practical actions to advance shared priorities across the Pacific. Photo Credit WHO/W Shahid}

Listening beyond the meeting room

The mission also provided an opportunity to listen directly to the people who experience these challenges.

Field activities in RMI and FSM brought partners together with health workers, communities and people affected by leprosy. Their experiences helped put the technical discussions into perspective.

For some people, the barrier may be distance. For others, it may be fear of being identified with leprosy. For a health worker, it may be recognising an early case while managing many other health priorities.

These are important details because interrupting transmission depends not only on medicines and guidelines, but on whether services actually reach people when they need them.

"The path towards interrupting leprosy transmission and achieving sustainable elimination will not look the same on every island," said Dr Roderico H. Ofrin, WHO Representative for FSM, RMI and Palau. "What matters is that countries have the tools, capacity and community partnerships to identify cases early, protect those at risk and sustain progress over time."

The discussions also emphasised the role of people affected by leprosy and their families. Their lived experience can help challenge stigma and discrimination, encourage earlier care-seeking and show programmes where services may be falling short.

Turning discussion into action

FSM, Kiribati and RMI are now translating the consultation into country-led action plans, focusing on earlier detection, stronger contact screening and surveillance, health-worker capacity and better access to services in remote communities.

With support from Sasakawa Health Foundation, WHO will continue working with countries to turn these priorities into practical, country-led action, while keeping people affected by leprosy at the centre.

“Our role is to support countries in turning their commitment to ending leprosy into practical action that reaches people and communities,” said Professor Takahiro Nanri, President of Sasakawa Leprosy initiative. “By working alongside governments and WHO, we hope to support approaches that countries can sustain, while keeping people affected by leprosy at the centre of this effort.”

A Pacific pathway forward

The path towards interrupting leprosy transmission will differ across Pacific countries and islands, but the priorities are clear: detect cases earlier, screen contacts, sustain surveillance, strengthen health services and engage communities.

Ultimately, progress means recognising signs earlier, screening contacts and ensuring everyone affected by leprosy receives timely, respectful care without fear or discrimination.

^{Representatives from FSM DHSA, WHO and the Sasakawa Health Foundation pose for a group photo during a visit to Madolenihmw Community Health Center, FSM highlighting the importance of partnership and community-based action in advancing efforts to interrupt transmission. Photo Credit WHO/W Shahid}