The Zero Leprosy Research Agenda outlines the research needed to reach no disease, no disability, and no discrimination or stigma.
In 2018, more than 140 participants from more than 20 countries convened in the Research Agenda Working Group to identify key research areas to reach zero leprosy. The Zero Leprosy Research Agenda, published in Infectious Diseases of Poverty in November 2020, focuses on eight main research areas, briefly outlined below.
Zero Leprosy Research Agenda
Epidemiologic modeling and socioeconomic research
- Feasibility of global interruption of leprosy transmission
- Potential impact of new strategies and tools
- Geographical variation and population at risk
- Impact of other epidemiological risk factors for transmission
- End-game scenarios
- Testing hypotheses
- Available tools and their economic feasibility
- Socioeconomic burden of leprosy
- Financial and cost analysis of leprosy and associated illness
Digital health
- Geolocalization of cases
- Digital diagnostics
- eLearning and hands-on training (with accreditation)
- Policy research, implementation, and tracking
- Independent evaluation of digital interventions (with scale-up plans)
Operational research
- Mapping
- Data management
- Monitoring and surveillance
- Health systems strengthening
- Drug-resistance surveillance
- Active case-finding
Diagnostics
- Potential use of digital technologies to help improve clinical diagnosis
- Nucleic acid-based tests
- Drug-resistance surveillance
- Reactions and relapses (including in the context of resistance)
- Diagnostic test based on detection of host immunity
- Testing for infection
- Non-human reservoirs
Post-exposure prophylaxis (PEP) and transmission
- Leprosy prevalence and surveillance
- Mapping of current and retrospective routine surveillance data
- PEP intervention effectiveness
- PEP effectiveness under routine conditions
- Detailed cost studies
- Quality of leprosy screening by minimally trained staff
- Surveillance for rifampicin resistance in leprosy
- Field-friendly diagnostic tests
- Frequency of single dose rifampicin (SDR) in high endemic settings
- Other drugs for PEP
- PEP for high-risk contacts
- Disturbance of gut microbiome through PEP
- Combination of SDR and vaccines
- Human-to-human transmission
- Non-human reservoirs
- Host-pathogen interactions
- Transmission networks
Vaccines
- Safety monitoring
- Updates to Mycobacterium indicus pranii (MIP) vaccine and LepVax
- Coordination with WHO regarding criteria
- Range of early diagnostic tests
- Evaluation of clinical trial sites
- Clarification for study design and evaluation parameters
- Target product profiles
Disability
- Early detection of leprosy to prevent disability
- Pathophysiology, detection, and management of nerve function impairment and reactions
- Number of people with disability due to leprosy
- Prevention of disability and its worsening
- Inclusive rehabilitation services
- Community-based rehabilitation
Stigma
- Interventions to reduce stigma as a barrier to zero leprosy
- Understanding perceptions of leprosy and the reasons behind them
- Mental well-being of persons affected by leprosy
- UN principles and guidelines for the elimination of discrimination