Fw: Ref.: (LML) Reflecting on 2025: Progress, Partnership, and a Sustainable Future

 

 

Leprosy Mailing List –  July 27,  2026

 

Ref.:  (LML) Reflecting on 2025: Progress, Partnership, and a Sustainable Future

From: LRI, Amsterdam, the Netherlands

____________________________________________________________________________

 Dear colleagues,

 

 

Reflecting on 2025: Progress, Partnership, and a Sustainable Future
The Leprosy Research Initiative (LRI) continues to support its mission of promoting and funding high-quality research, translating evidence into policy and practice, and strengthening research capacity in endemic countries. Together with our partners, researchers, and stakeholders, we remain united by a shared vision: a world free from leprosy.

As we reflect on 2025, we do so with both gratitude and determination. Throughout the year, we built on LRI’s strong foundation by advancing innovative research, strengthening research capacity, fostering collaboration, and preparing for future opportunities and challenges.

One of the highlights of the year was the launch of 10 new research projects, alongside the awarding of six new grants through two competitive grant cycles. These included three grants under the Research Capacity Strengthening programme and three grants through the RESILIENTD programme, funded by the Anesvad Foundation, which focuses on addressing the social determinants of skin Neglected Tropical Diseases (NTDs) in Sub-Saharan Africa.

Learn more about these grants:

• Research Capacity Strengthening grants
• RESILIENTD grants

Collaboration and knowledge sharing remained central to our work. The 10th LRI Spring Meeting brought together nearly 200 researchers and stakeholders from around the world, reflecting the growing engagement and strength of the global leprosy research community.

A significant milestone this year was the completion of LRI’s second external evaluation. The findings confirmed the continued relevance of our work while providing valuable recommendations to guide our future development. Building on these insights, we initiated the development of LRI’s first Multi-Annual Strategic Plan and began updating our research priorities to ensure our efforts remain focused, responsive, and impactful.

At a time when financial constraints across the global health and research sectors require thoughtful planning, LRI is adapting to ensure long-term sustainability. Beginning in 2026, we will adopt a biennial grant cycle model, alternating between flagship research calls and capacity-strengthening calls. This predictable framework will enable LRI to continue supporting research excellence while investing in future research leaders.

As we look ahead to 2026, we do so with a clear strategy, a focused mission, and confidence in the power of research to contribute to a world free of leprosy.

We extend our sincere thanks to our partners, committee members, researchers, donors, and the wider leprosy research community. Your commitment, expertise, and collaboration make our work possible and strengthen our collective impact.

Interested in learning more? Read the full LRI Annual Report 2025 to explore our achievements, impact, and future priorities.

 

Warm regards

 

____________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

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Fw: Ref: (LML) LAMP: a breakthrough

 

Leprosy Mailing List –  July 27,  2026

 

Ref.:  (LML) LAMP: a breakthrough

From: Joel Almeida, Mumbai, the Netherlands

____________________________________________________________________________

 

Dear Pieter and colleagues,

LAMP was invented in 2000. (1) It can be used for a wide range of pathogens (not just M. leprae or M. lepromatosis or leishmania etc (2) but the whole range of viral or bacterial or parasitic or other pathogens). Nasal swabs have the advantage of being relatively non-invasive. They also allow the simultaneous detection of a range of viral and other pathogens if needed.

In Hansen Disease (HD), the detection of asymptomatic cryptic LL is particularly important.

Many labs in endemic countries have been developing locally relevant versions. In India, the ICMR National Institute of Pathology, the ICMR JALMA Institute, the PGI medical and research institute (Chandigarh) and others are known to have their own versions. Technology institutes such as the IITs have developed low-cost supporting technology. Also labs in Brazil, China and elsewhere.

There is no need for HD to lag behind other diseases in the use of such user-friendly field technology. Partnership with a university / medical institute / lab will enable organizations of persons with lived experience to lead the charge against the bacillus.

Such technological breakthroughs keep shrinking the room for pessimism. The prospects of rapid progress grow.

With all sincerity,

Joel Almeida

                                               References

1.            T Notomi, H Okayama, H Masubuchi, T Yonekawa, K Watanabe, N Amino, T Hase.  Loop-mediated isothermal amplification of DNA  Nucleic Acids Res  2000 Jun 15;28(12):E63. doi: 10.1093/nar/28.12.e63.

2.            Joshi, S.; Dixit, K.K.; Sharma, V.; Ramesh, V.; Singh, R.; Salotra, P. Rapid Multiplex Loop-Mediated Isothermal Amplification (m-LAMP) Assay for Differential Diagnosis of Leprosy and Post–Kala-Azar Dermal Leishmaniasis. Am. J. Trop. Med. Hyg. 2021, 104, 2085–2090.  

____________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

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Fw: Ref.: (LML) First International CME Webinar of the IAL Academy | 29 July 2026 | Scientific Programme

 

Leprosy Mailing List –  July 26,  2026

 

Ref.:  (LML) First International CME Webinar of the IAL Academy | 29 July 2026 | Scientific Programme 

From: Sunil Dogra, Chandigarh,  India.

____________________________________________________________________________

Dear Colleagues/ IAL & ILA members / Leprosy Researchers/ ILEP Partners,

Greetings from the IAL!

It gives us immense pleasure to invite you to the First International CME Webinar of the IAL Academy, the academic arm of the Indian Association of Leprologists.

Theme:  Leprosy in 2026: Clinical Challenges & Emerging Horizons

Date: Wednesday, 29 July 2026
Time: 7:00 PM IST onwards
 Platform: Zoom [Link attached - will become active 30 mins before scheduled time]
Meeting ID: 826 1623 4423
Passcode: IAL

This inaugural international webinar has been organized by the Clinical & Therapeutics Leprosy Focus Group of the IAL Academy and brings together a panel of eminent national and international experts. The programme features a keynote address by Dr Vishwa Mohan Katoch ) Former Secretary, DHR ( MoHFW, GoI) & DG, ICMR), renowned faculty including Prof. Ben Naafs (The Netherlands) and Dr Chathurarya Siriwardena & Dr Indira Kahawita (Sri Lanka), and an interactive panel discussion on therapeutic dilemmas in leprosy.

The webinar is designed for dermatologists, leprologists, physicians, postgraduate students, researchers, microbiologists, public health professionals, National & International Leprosy Programme personnel, physiotherapists, rehabilitation specialists, and all healthcare professionals involved in leprosy care.

Participation is free, and we encourage all members to actively participate and benefit from the latest evidence, expert insights, and practical clinical discussions. Webinar access details are available in the programme brochure.

The final scientific programme is attached for your reference.

We request you to circulate this announcement widely among your colleagues, departments, institutions, and postgraduate students so that the maximum number of healthcare professionals can benefit from this academic initiative.

We look forward to your enthusiastic participation in making this inaugural international webinar of the IAL Academy a grand success.

With warm regards,

--

Dr Sunil Dogra  

President    

Indian Association of Leprologists (IAL) 2026-2028

https://www.ial-leprosy.org        Email: ialoffice2026@gmail.com

---------- 

Sunil Dogra  

               MD, DNB. FAMS, FAAD, Dip Dermatology (Glasgow), FRCP (London), FRCP (Edinburgh)

Professor, Department of Dermatology, Venereology & Leprology

Postgraduate Institute of Medical Education & Research (PGIMER)

Chandigarh, 160012, India. I pgimer.edu.in I sundogra@hotmail.com  

 

____________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

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Fw: Ref.: (LML) Semi-quantitative mLAMP for the laboratory confirmation of leprosy

 

 

Leprosy Mailing List –  July 24,  2026

 

Ref.:  (LML) Semi-quantitative mLAMP for the laboratory confirmation of leprosy

From: Pieter Schreuder, Maastricht, the Netherlands

______________________________________________________

 

Dear colleagues,

 

In recent publications in LML Joel Almeida (Mumbai, India) has repeatedly referred to the semi-quantitative mLAMP for the laboratory confirmation of leprosy as an important new tool to detect those in the community who are most likely responsible for the spreading of M.leprae. In those studies clinical samples like skin biopsies and slit-skin smears rather than explicitly restricting or defining the assay protocol around nasal swaps alone. The claim is that the test can be used under field conditions: isothermal, no thermocycler, no cold chain, naked-eye readout of colour or turbidity.

 

One of those studies he referred to was from Malkin Saar and co-authors:

Malkin Saar, Marcus Beissner, Fatih Gültekin, Issaka Maman, Karl-Heinz Herbinger , Gisela Bretzel: RLEP LAMP for the laboratory confirmation of leprosy: towards a point-of-care test. BMC Infect Dis. 2021 Nov 25;21:1186

Abstract

Nucleic acid-based amplification tests (NAAT), above all (q)PCR, have been applied for the detection of Mycobacterium leprae in leprosy cases and household contacts with subclinical infection. However, their application in the field poses a range of technical challenges. Loop-mediated isothermal amplification (LAMP), as a promising point-of-care NAAT does not require sophisticated laboratory equipment, is easy to perform, and is applicable for decentralized diagnosis at the primary health care level. Among a range of gene targets, the M. leprae specific repetitive element RLEP is regarded as highly sensitive and specific for diagnostic applications. Conclusion:the ready-to-use RLEP DRB LAMP assay constitutes an ASSURED test ready for field-based evaluation trials aiming for routine diagnosis of leprosy at the primary health care level.

For those interested or even planning any leprosy survey it is strongly advised to read the original publications.

With many thanks to Joel Almeida.

 

Best regards,

 

Pieter AM Schreuder

___________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

 

 

 

 

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Fw: Ref.: (LML) FIND TREAT END (FTE)

 

Leprosy Mailing List –  July 18,  2026

 

Ref.:  (LML) FIND TREAT END (FTE)

From: Joel Almeida, Mumbai, India

____________________________________________________________________________

 

 

Dear Pieter and colleagues,

For a long time M. leprae have outwitted us. A central challenge is that persons who look completely normal, with zero signs or symptoms, can shed astronomical numbers of viable bacilli in nasal discharges. Also, reinfection means that a cluster-wide sweep is needed.

The FIND TREAT END strategy relies on user-friendly reliable and scalable tools to rapidly eliminate concentrated viable bacilli from nasal discharges in a human cluster, while protecting nerves, eyes, hands, feet and helping to generate jobs for persons with lived experience. They often live in endemic areas.

·  FIND: Barcoded, georeferenced nasal swab screening of all asymptomatics in clusters and migratory corridors using semi-quantitative mLAMP (isothermal, no thermocycler, no cold chain, naked-eye readout of color or turbidity). This rapidly distinguishes persons with high-shedding cryptic asymptomatic LL (unique sources of concentrated viable bacilli) from casual nasal carriers of trivial numbers of bacilli. Swab collection can even be by an army of persons with lived experience after basic training. Reporting is in real time via mobile phone apps with georeferences.

·  TREAT: Prompt full anti-microbial treatment started for only high-shedders and clinical cases, combined with regular nerve function monitoring via four simple muscle weakness tests performed by trained persons with lived experience who also encourage uninterrupted completion of treatment. This eliminates concentrated viable bacilli in nasal discharges of the local human population within days/weeks. Silent nerve damage is more likely to be detected.

·  END: Periodic mop-up surveillance rounds to confirm and sustain the elimination of concentrated viable bacilli from the cluster.

Elimination of concentrated viable bacilli in nasal discharges from a human cluster can be demonstrated within days/weeks, using nasal swabs. Cluster by cluster, in sequence or in parallel, the success can sweep across whole districts, countries and beyond. Go into a cluster on Monday, do a sweep for nasal swabs & semi-quantitative mLAMP by Tuesday, start full treatment on Wednesday of every cryptic asymptomatic LL high-shedder. Take nasal swabs in periodic follow-up sweeps. It used to require decades to make a dent in transmission, now it is possible in weeks. That is because no cryptic asymptomatic LL high-shedder goes undetected or unprotected..

The entire system is designed to be literacy-independent, helping to rehabilitate persons with lived experience through dignified employment as aides to health workers. Persons with lived experience can also assist with respectful rehab and obtaining social entitlements while steadily replacing public fear with public respect. Health workers, universities and experts can guide and document the grassroots activities and their impact. 

 

The FIND TREAT END strategy not only rapidly stops transmission but also conserves macrophage defences by confining anti-microbial use to only high-shedding asymptomatic LL cases and any persons with clinical signs of HD.  Socio-economic improvements and BCG or MIP or other vaccines would support the strategy. 

Cluster by cluster, the FIND TREAT END strategy can make a thousand Maltas bloom. This is a vision that can compete successfully for investments in an era of financial constraints, because it offers rapid, measurable payoffs.  

With all sincerity,

Joel Almeida

____________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

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Fw: Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works (LML 9 July 2026)

 

 

Leprosy Mailing List –  July 11 ,  2026

 

Ref.:  (LML)  Long-lasting adverse impact of chemoprophylaxis & what actually works (LML 9 July 2026)

From:  Joel Almeida, Mumbai, India

____________________________________________________________________________

 

Note editor: In the LML communication of July 9, 2026, we mistakenly did not add  the figure with the municipalities with a history of PEPHans and municipalities without a history of PEP

 

Dear Pieter,


Quote: " Despite more intensive contact tracing in recent years, the former PEPHans areas* show a long-lasting higher risk of MB and G2D (visible deformity at diagnosis) compared to non-PEP Maranhão municipalities. "

The mentioned figure you will find in the attached file!

 

* PEPHans municipalities:

a) Mato Grosso: Alta Floresta, Apiacás, Carlinda, Nova Bandeirantes, Nova Monte Verde, Paranaíta, Rondonópolis;
 b) Pernambuco: Afrânio, Cabrobó, Dormentes, Lagoa Grande, Orocó, Petrolina, Santa Maria da Boa Vista;
 c) Tocantins: Araguaína, Colinas do Tocantins

____________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

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Fw: Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

 

 

Leprosy Mailing List –  July 9,  2026

 

Ref.:  (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works

From: Joel Almeida, Mumbai, India

____________________________________________________________________________

 

 

Dear Pieter and colleagues,

Brazil tried short-term chemoprophylaxis (PEP in PEPHans pilots 2016-2019) and then rejected it. The attached figure underlines how scientifically robust and beneficial this rejection was. Despite more intensive contact tracing in recent years, the former PEPHans areas* show a long-lasting higher risk of MB and G2D (visible deformity at diagnosis) compared to non-PEP Maranhão municipalities. 

Understanding the biology of macrophages is important for rapidly and safely eliminating concentrated viable bacilli from human clusters.

Intact macrophage defences are the primary reason most infected individuals never develop signs of disease,(1) despite widespread asymptomatic subclinical infection in endemic areas.(2) However, M. leprae debris including DNA in macrophage cytosol subverts natural macrophage defences via the highly conserved and universal cGAS-STING-IRF3-IFNB-OASL cascade, suppressing autophagy and vitamin D-induced cathelicidin.(3) Short-term chemoprophylaxis damages bacilli by anti-microbial action, producing debris in macrophage cytosol, but does not outlast the bacillary debris given the suppression of autophagy. Nor does it prevent subsequent reinfection or regrowth in disarmed macrophages. Bacillary replication is via cell pole elongation (4) with increased surface area and surface virulence factors per bacillus, including Mce1A for cell entry (5) and PGL1 for “silent” non-inflammatory damage to axonal mitochondria via perineural macrophage iNOS and excess nitric oxide.(6)

Accordingly, a boost in phenotypically high-virulent bacilli is expected to outlast chemoprophylaxis. Also, the circulation of these high-virulent bacilli is predicted to boost the risk of MB HD and G2D, as illustrated in the attached figure. 

A central requirement for rapidly eliminating concentrated viable bacilli from human clusters is to conserve natural macrophage defences: boost nutrition, use BCG or MIP or similar vaccines (macrophage autophagy boosters), confine anti-microbial use to high-shedding asymptomatic LL (millions of bacilli in nasal swabs) or persons with physical signs of HD. Continue socio-economic improvements (literacy, employment etc).

São Luís in Maranhão is producing among the world's most rapid declines of new MB HD: eg from 279 new MB in 2023 to only 200 in 2025. With addition of nasal swabs for rapid semi-quantitative mLAMP to detect cryptic asymptomatic LL high-shedders, followed by full anti-microbial treatment with regular check-ups to preserve nerve function, such high-endemic low-income places can end transmission within weeks rather than decades. Periodic mop-up rounds would be needed to confirm and sustain the success.

Is it a bad idea to conserve natural macrophage defences?

With all sincerity,

Joel Almeida

References                 

1.                 Mi Z, Liu H, Zhang F. (2024) Advances in thepathogenic, genetic and immunological studies of leprosy. hLife 2024;2:6–17.

 

2.                 Godal T, Negassi K (1973). Subclinical infectionin leprosy. Br Med J. 3 (5880): 557-559

 

3.                 deToledo-Pinto TG, Ferreira ABR, Ribeiro-Alves M et al. (2016)STING-Dependent 2′-5′ Oligoadenylate Synthetase–Like Production Is Required forIntracellular Mycobacterium leprae Survival. The Journal of InfectiousDiseases, Volume 214, Issue 2, 15 July 2016, Pages 311–320,https://doi.org/10.1093/infdis/jiw144

 

4.                 Hannebelle MT, Ven JX, Toniolo C et al.(2020)  A biphasic growth model for cell poleelongation in mycobacteria. Nature Communications 11:452https://doi.org/10.1038/s41467-019-14088-z

 

5.                 Fadlitha VB, Yamamoto F, Idris I, Dahlan H, SatoN, Aftitah VB, et al. (2019) The unique tropism of Mycobacterium leprae to thenasal epithelial cells can be explained by the mammalian cell entry protein 1A.PLoS Negl Trop Dis 13(3): e0006704.https://doi.org/10.1371/journal. pntd.0006704

 

6.                 MadiganCA, Cambier CJ, Kelly-Scumpia et al (2017). A macrophage response toMycobacterium leprae phenolic glycolipid initiates nerve damage in leprosy. Cell. 170(5):973-985. e10.
- - - -

* PEPHans municipalities:

a) Mato Grosso: Alta Floresta, Apiacás, Carlinda, Nova Bandeirantes, Nova Monte Verde, Paranaíta, Rondonópolis;
 b) Pernambuco: Afrânio, Cabrobó, Dormentes, Lagoa Grande, Orocó, Petrolina, Santa Maria da Boa Vista;
 c) Tocantins: Araguaína, Colinas do Tocantins

____________________________________________________________________________

LML - S Deepak, B Naafs, S Noto and P Schreuder

LML blog link: http://leprosymailinglist.blogspot.it/

Contact: Dr Pieter Schreuder << edit...@gmail.com

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