The World Health Organization (WHO) has confirmed that leprosy medications will finally arrive in Nigeria this weekend, following a year-long delay caused by bureaucratic hurdles and domestic testing regulations. The shortage left thousands of patients, including children, without treatment, increasing their risk of severe disabilities.
Nigeria, Africa’s most populous nation, records over 1,000 leprosy cases annually. The disease, caused by Mycobacterium leprae, primarily affects the skin, peripheral nerves, and eyes. While it is curable with multi-drug therapy (MDT), untreated cases can lead to disfiguring sores, paralysis, and blindness, along with severe social stigma.
Supply Disruptions and Regulatory Delays
Nigeria’s stock of multi-drug therapy ran out in early 2024 due to delays in shipments and new domestic testing requirements for imported medicines. The medications, produced in India, were stuck in regulatory limbo, preventing distribution.
The WHO, responsible for coordinating global leprosy drug shipments, sought a waiver on Nigeria’s new testing policy to expedite deliveries. This waiver was granted in January 2025. Now, the first batch of leprosy medications is set to arrive from India on March 9, 2025, the WHO confirmed.
Impact of the Shortage
The lack of medication severely impacted patients at facilities like ERCC Hospital in Nasarawa, where only two leprosy patients remained admitted as of February 2025. The hospital was forced to send home 26 other patients, increasing the risk of disease transmission through respiratory droplets and prolonged contact.
One of the patients, Awwal Musa, described the deterioration of her condition over the past year, saying,
“Before last year, my wounds were healing, but now they are getting worse. The pain is worse.”Healthcare workers expressed deep concern over the rising complications among untreated patients. Kuzeh Thomas, a hospital director, warned,
“If they lose their fingers, where are you going to get the fingers and give them again? If they lose their sight, who will give them sight?”
Systemic Challenges in Leprosy Drug Distribution
Nigeria is one of 12 countries reporting between 1,000 to 10,000 leprosy cases annually, alongside Brazil, India, and Indonesia. Each country requests MDT doses from WHO yearly, but sources indicate that Nigeria’s request was delayed this time.
The medications, donated by Novartis, faced additional regulatory scrutiny upon arrival in Nigeria. The National Agency for Food and Drug Administration and Control (NAFDAC) required extra testing for Sandoz-produced components from Indian facilities, further prolonging the supply delay.
A spokesperson for Sandoz declined to share specific supply details, while Novartis reaffirmed its commitment to leprosy eradication without elaborating further. The Indian laboratory Quontrol inspected the drugs but did not publicly release test results. The medications were finally approved in December 2024 after being submitted for testing in November.
Calls for Systemic Reforms
Experts warn that the leprosy drug distribution system, while structured on paper, faces severe operational and political challenges. Beatriz Miranda-Galarza, the U.N. Special Rapporteur on Leprosy, noted,
“While the MDT distribution system appears well-structured on paper, in practice, it faces significant structural and political challenges.”Meanwhile, Sunday Udoh, head of the Leprosy Mission Nigeria, described the crisis as unprecedented, stating,
“This is the first time we are seeing this kind of very strange, very painful situation where leprosy patients, who belong to the poorest of the poor, are unable to access this life-saving medication.”
With the long-awaited medications now set for delivery, health authorities and advocates are calling for stronger regulatory coordination to prevent future disruptions and ensure continued access to essential treatments for Nigeria’s most vulnerable populations.
