When Sharadindu Ghosh* was young, he was taught not to speak about his father’s leprosy. He, like many others, grew up in the lanes of Jamuria Leprosy Colony, in West Bengal, facing stigma and discrimination. Today, years after his father’s passing and an endless struggle through poverty, Ghosh is an electrical supervisor and a mentor to local children. “Among the uneducated population in India, people believe that this disease is given by God,” said Mervyn Basil, communications specialist at NGO Until No Leprosy Remains-India (NLR-India).
Leprosy was eliminated as a public health problem in India as per the World Health Organization’s criteria of less than 1 case per 10,000 population, at the national level, in 2005. However now, experts say, it is quietly resurfacing, particularly in climate stressed States including West Bengal and Bihar. Floods, displacement and overcrowding have become frequent, leading to these States seeing the disease re-emerge in pockets.
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The climate change-leprosy link
India reported total 1,03,819 new leprosy cases for the year 2022-23 out of which grade 2 disability (G2D) cases were 2,363 (2.28%), amounting to 25% of the new G2D cases of the world, as per a statement given in the Lok Sabha in February 2024.
Extreme weather events do not affect all communities equally, and people affected by leprosy often face risks far beyond those encountered by the general population. Research presented by James Pender at the 21st International Leprosy Congress in 2022 highlighted how climate -induced disasters disproportionately affect leprosy-affected communities. Floods cause the loss of homes, crops and in some cases even access to shelters. Those with leprosy-related disabilities are often left behind in evacuation efforts and many face discrimination at relief camps. In Bangladesh, for instance, over 4,000 people affected by leprosy were impacted by severe flooding in 2017 and many were denied basic disaster relief.
India is ranked amongst the most climate-vulnerable nations globally and the intersection of disease, climate change and economic deprivation can further deepen the gaps. According to a report by the Leprosy Mission Trust India, States including Bihar, Jharkhand, Uttar Pradesh, Odisha and Chhattisgarh are also home to the largest proportion of people living in multidimensional poverty, meaning poverty that goes beyond money and wealth.
“Leprosy is a tropical disease and in tropical areas, there is a higher chance of this bacteria multiplying at a very rapid pace, and it’s quite possible that it will multiply quickly,” said Mr. Basil.
Eight districts across Bihar, West Bengal, Odisha and Maharashtra report a high climate vulnerability, widespread multidimensional poverty and endemic levels of leprosy prevalence.
According to Bihar’s State Water Resources department, 68.80 lakh hectares or over 76% of north and 73% of south Bihar are regularly affected by floods. A total of 28 of the State’s 38 districts are declared flood-prone.
In Odisha, the situation may be worse: it remains one of India’s most climate disrupted states. According to the Council on Energy, Environment and Water, 26 districts in Odisha are exposed to extreme climate events. The State has witnessed an increase in cyclonic events of late, with Koraput routinely facing floods that disrupt agricultural productivity and impact village residents who are primarily agricultural workers. With high risks of flood and drought, the State has a leprosy prevalence rate of 0.89.
Chhattisgarh is also emerging as a key hotspot, with multiple districts like Bijapur, Kabirdham and Mahasamund having high prevalence rates of leprosy and deep rooted poverty.
Kishanganj in Bhihar, Raigarh in Chhattisgarh and Nuapada in Odisha have reported leprosy prevalence rates above 3% coexisting with poverty levels that exceed 60% in some cases. Even in relatively better-off states like Maharashtra and West Bengal, vulnerability in clusters exists especially in tribal areas like Nandurbar and Jhargram.
Triple jeopardy
Shubhojit Goswami, senior programme manager at Leprosy Mission Trust India said: “Our report does not claim or suggest that changes in climate patterns lead to leprosy transmission. But extreme climate events like floods, cyclones and droughts increase risk factors like malnutrition, limit access to clean water and poor hygiene which are known to contribute to leprosy spread”
Displacement emerges as another key concern. When residents of rural areas face climate shocks like floods or droughts, they tend to migrate to urban areas. “Many can only afford to live in overcrowded slums and high population density increases the transmission risk,” said Mr. Goswami.
He cites the example of Shravasti district in Uttar Pradesh, where heavy floods in October 2022 came just months after a drought had already devastated agriculture. “This kind of back-to-back climate shock is becoming the new normal,” he pointed out. Shravasti is a high-endemic district for leprosy where more than 70% of the population lives in multidimensional poverty.
The need for interventions
Urgent interventions by government and NGOs are needed. Three steps that Mr. Goswami states as urgent are: building community resilience alongise awareness programmes on climate-adaptive health behaviour; strengthening health systems in leprosy endemic districts to mitigate climate shocks as well as hyper-local climate and health risk assessments.
A total of 30 districts across India are at the risk of ‘triple jeopardy’ i.e. the disease, climate change and poverty coexisting. “These triple burdens often affect specific districts and not entire States,” said Mr. Goswami. Muzaffarpur in Bihar for instance, suffers from co-endemic diseases like leprosy and filariasis, and it floods every year. These districts should receive prioritised resources and support, he said.
Districts such as Nandurbar in Maharashtra and Jhargram West Bengal have tribal populations living in relatively wealthier states and endemic leprosy still exists. “People need to understand how both leprosy and climate interact, but this can only happen when investments in local health systems are capable of reading and reacting to climate data,” said Mr. Basil.
“Initiatives related to climate change have not been undertaken as yet as there is a lack of funding. As of now, no climate change organisation is actively working on leprosy-related impacts. Thematic donor support is a major problem as climate change itself is a new subject,” Mr. Basil adds.
Reaching the last mile
“People affected by leprosy are often the last to receive medical care during disasters like floods and it is not always that they don’t want to go to the hospital, it is the social stigma that affects their decisions. There exists a fear that they will be turned away or harassed by others at relief centers or hospitals,” said Mr. Basil.
Climate change is causing cracks in our public health systems. The time to act is now, as leprosy is not going to disappear: it demands urgent interventions, visibility, and funding.
*Name changed on request, to protect privacy
(Aditya Ansh is an independent media reporter based in New Delhi. His work covers environment, climate, health, education and human rights. adityaansh30@gmail.com)
Published – June 07, 2025 07:00 am IST
