MoLEP-Co-creating a Mycobacterium leprae transmission interruption program for the Morogoro region, Tanzania.

Abstract

The global goal for leprosy elimination is the interruption of Mycobacterium leprae transmission, resulting in zero new leprosy patients. In alignment with this objective, Tanzania's updated national leprosy strategy emphasizes early detection, systematic contact tracing, post-exposure prophylaxis (PEP) with single-dose rifampicin (SDR), and integration of services into primary health care. However, the feasibility of accelerating M. leprae transmission interruption in high-burden areas with this strategy has yet to be demonstrated. In 2024, the Morogoro Leprosy Elimination Program (MoLEP) was launched in the country's most endemic region. Developed through a collaborative process, MoLEP aligns global practices with local conditions and needs. Key interventions include training frontline health workers and expanding contact tracing with SDR-PEP. Furthermore, targeted activities will respond to high transmission areas and the detection of child cases, which serve as indicators of recent transmission. Strengthening the drug supply chain is also a priority. MoLEP will generate critical data on the feasibility and effectiveness of these interventions in accelerating progress toward elimination. The implementation is guided by a comprehensive monitoring and evaluation framework, alongside clearly defined governance structures, to facilitate evidence-informed decision-making. Findings are expected to guide strategic scaling and replication in other high-burden regions across Tanzania and beyond.