New vaccine could cut leprosy cases in India by 60%

The Indian government is testing a vaccine that could cut the number of new reported cases of leprosy by 60% in three years in the targeted districts.

The vaccine will be rolled out in a project involving five districts in the states of Bihar and Gujarat, where there are high rates of the disease.

People affected by leprosy as well as their families and other people who come into close contact with them on a regular basis, such as colleagues, will benefit from the project, making India the first country in the world to have a large-scale leprosy vaccination initiative.

The vaccine, mycobacterium indicus pranii (MIP), will be administered in combination with a single dose of the drug rifampicin, which is already being trialed in several countries to prevent leprosy in those who have been exposed to family members who already have the disease.

A recent study by The Leprosy Mission in Bangladesh found that new leprosy cases among people who had been given a single dose of rifampicin were almost 60%fewer than among those who had been given a placebo.

According to the World Health Organisation India made up 60% of worldwide reported new cases of leprosy highlighting the need for action.

Experts believe that these figures represent just a fraction of the true picture of people affected by leprosy. Lack of awareness, insufficient access to medical treatment and severe stigma surrounding leprosy mean that millions more could be living with the effects of the disease, going untreated.

The government are aiming to eradicate the disease by 2020 by using what Dr Soumya Swaminathan, director general of the Indian Council of Medical Research, has called a “multi-pronged attack” on the disease.

The vaccination project is being combined with a more active approach to the detection of new cases. Door-to-door screenings in 50 leprosy ‘hotspots’ have already seen 5,000 people newly diagnosed.

Tests of the MIP vaccine took place in 2005 and showed it being effective for seven to eight years, after which a booster dose would need to be given.

Certain leprosy experts have urged caution however with Dr Uptal Sen Gupta, consultant at The Leprosy Mission Trust India’s Stanley Browne Laboratory in Delhi saying: “Unless we improve the living conditions, health and hygiene of our people, we cannot eradicate leprosy.”

Dr Paul Saunderson, medical director at American Leprosy Missions, referenced the vaccine’s ability to cut new case by up to 60% but said: “MIP is an affordable and practical vaccine for leprosy, but relatively weak in terms of protective effect.”

He added that the vaccine has the potential to be combined with other treatment to be more effective – for example the single dose of rifampicin that will be given as part of the Indian project – but that at this point, it is unknown what the outcome of this will be.