Leprosy in the Pacific Islands: progress, gaps, and implications for the WHO 2030 elimination roadmap. — The Association Specialists
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  2. Oral Presentations - Communicable disease epidemiology and action
  3. Leprosy in the Pacific Islands: progress, gaps, and implications for the WHO 2030 elimination roadmap.

Leprosy in the Pacific Islands: progress, gaps, and implications for the WHO 2030 elimination roadmap. (23942)

Sebastian Vernal 1 , Adam Craig 1
  1. The University of Queensland, Brisbane City, QLD, Australia

Background. The WHO Global Leprosy Strategy 2021–2030 aims for a 70% reduction in new cases, a 90% reduction in Grade 2 disability (G2D), and a 90% reduction in child cases from 2020 baselines.1 The Pacific Islands countries (PICs) carry a disproportionate per capita burden, yet their epidemiology remains incompletely characterised.2 We aimed to describe key patterns in leprosy across PICs.

Methods. We analysed the WHO Global Health Observatory3 leprosy surveillance data from 2012 to 2024 for 13 PICs. We assessed the new case detection rate, the G2D rate as a proxy for delayed diagnosis, and the child case rate as a proxy for ongoing transmission. Time-series analyses were used to describe temporal trends, post-2020 changes, and reporting gaps.

Results. Since 2012, 7,652 new leprosy cases have been reported from the 13 PICs, including 1,339 after 2020. The highest annual mean incidences after 2020 were reported in Kiribati and Micronesia (1,151.75 and 767.93 new cases/million, respectively). Although rates declined in the Marshall Islands and Micronesia, both remained relatively high in 2024 (612.5 and 689.3 new cases/million, respectively); rates in Kiribati remain high (1,212.0 new cases/million). These three countries had the highest concentrations of new cases in children. By 2024, increasing trends (relative change from 2020) were observed in Fiji (+164.9%), the Solomon Islands (+162.4%), Vanuatu (+167.8%), and Tuvalu (+117.8%; with no data for 2023-2024). G2D was reported inconsistently across countries. Missing data after 2020 were frequent in Nauru and Samoa. The Cook Islands and Niue have reported zero cases since 2012, but data were not reported every year.

Conclusion. Several PICs are not on track to reach leprosy elimination targets by 2030. Persistent high incidence, child cases, G2D, and surveillance gaps suggest delayed diagnosis and inadequate treatment, and possible underdetection.

  1. World Health Organization. Towards Zero Leprosy: Global Leprosy (Hansen’s disease) Strategy 2021–2030, 2021. Available at: https://www.who.int/publications/i/item/9789290228509. Accessed April 24, 2026.
  2. Crawford C. The leprosy problem in the South Pacific. The New Zealand Medical Journal. 2014; 127(1394): 91-93.
  3. World Health Organization. The Global Health Observatory, Leprosy (Hansen Disease). Available at: https://www.who.int/data/gho/data/themes/topics/leprosy-hansens-disease. Accessed April 24, 2026.