Leprosy Elimination Monitoring Tool

The Leprosy Elimination Monitoring Tool (LEMT) has been developed based on the Leprosy Elimination Framework.

• Promote a standard way to monitor progress towards interruption of transmission and elimination of leprosy disease in detail, and to
• Promote a bottom-up process of building up evidence for interruption of transmission and elimination of leprosy disease.

The Leprosy Elimination Framework was developed based on the work and recommendations of the taskforce on criteria for elimination of leprosy (TFCEL) with the aim to identify key concepts, definitions, indicators and milestones to be used by countries on the road to interruption of transmission and elimination of leprosy disease. The Leprosy Elimination Framework provides a systematic and standardised way of tracking country progress in their fight against leprosy. WHO has developed technical guidance for countries working to achieve the milestones of interruption of transmission and elimination of leprosy disease using the Leprosy Elimination Framework. The technical guidance highlights important concepts and definitions regarding leprosy elimination and includes the newly developed Leprosy Elimination Framework showing the phases of elimination and the associated indicators and milestones. The LEMT is based on these ‘phases of elimination’ and visually displays country progress towards the milestones on a national and subnational level, using the traffic light-colouring scheme that corresponds to the Leprosy Elimination Framework.

The Leprosy Elimination Framework distinguishes two phases of elimination, a post-elimination phase and the subsequent non-endemic status (Figure 1). An area or country transitions to the next phase when it achieves the corresponding milestone. To visualise and assess the progress in detail, the LEMT can be applied at any subnational level for which long-term data are available. The sub-national levels can then be added up to show progress at higher administrative levels. The status of elimination is likely to vary greatly between different administrative units at one particular level, e.g., district or municipal level, and across the administrative levels. At a national level, certain countries may seem far from achieving the milestones, however, the leprosy situation may look more favourable at provincial/state or district/municipal level. Implementation of the LEMT at a subnational level stimulates a bottom-up process in which each of the administrative areas individually pursues the achievement of the set milestones. Hence, when all districts (or equivalent) in a province (or equivalent) have reached a certain milestone, that province will have reached the set milestone also. Ministries of health are encouraged to verify and acknowledge these achievements. At the same time, areas shown to be in Phase 1 or 2 should be flagged as needing additional resources to help them achieve the milestones also. Once the milestones of interruption of transmission and elimination of leprosy disease have been reached at the national level, a country can request WHO for formal verification.