Pathfinder
Editor, Senior Moderator
Cases of leprosy are multiplying in Haiti
PAR Lucnise Duquereste•June 8, 2026
Eighteen patients were receiving treatment for leprosy in Gonaïves in March. Since the beginning of this year, five cases of the disease have been confirmed in Artibonite. Two others have also been confirmed in Marigot.
Confirmed cases of leprosy are increasing in Haiti.
In March, eighteen patients were receiving treatment for the stigmatized disease in Gonaïves. Since the beginning of this year, five cases have been confirmed in Artibonite. Two cases have also been confirmed in Marigot, in the Southeast.
The available data on new cases remains limited, but it is concerning enough to mobilize the Ministry of Health and its partners.
For specialists, the recently detected cases do not necessarily mean that the disease is progressing further today.
They reveal above all a transmission that could have gone unnoticed for several years, in a context where access to care, health monitoring and screening have been weakened by the multiple crises the country is going through.
Leprosy, a chronic infectious disease caused by the bacterium Mycobacterium leprae and affecting mainly the skin and peripheral nerves, remains one of the most stigmatized diseases in the world.
This reality still leads some people to hide their symptoms or delay seeking medical advice, even though effective and free treatment can cure the disease and interrupt its transmission.
Haiti struggles to measure the extent of the population affected by this disease, which has been present since colonial times . An analysis conducted in 1996 showed that between 1977 and 1996, nearly 2,000 patients were recorded.
What is the true extent of the situation today? Which municipalities are affected and what challenges complicate the response?
To answer these questions, AyiboPost contacted, in writing, the WHO representative in Haiti, Dr. Oscar Barreneche, a physician specializing in public health and tropical infectious diseases.
Trained in public health and having held several positions in infectious disease control programs in Latin America and the Caribbean, Dr. Barreneche regularly speaks on issues of epidemiological surveillance and strengthening health systems.
AyiboPost: What is the current number of confirmed leprosy cases in Haiti? Do you have data on the profiles of those affected?
Dr. Oscar Barreneche: Field data collected in March 2026 reported eighteen patients under treatment in Gonaïves, five new confirmed cases since the beginning of the year in the Artibonite department, 1 case in Saint-Marc and four cases in Gonaïves, as well as two laboratory-confirmed cases in the commune of Marigot, Southeast department.
Among the identified cases, there is one adolescent with an advanced clinical form, suggesting an old and undetected transmission.
Detailed demographic data — distribution by age, sex, clinical form — are being consolidated by the MSPP (Ministry of Public Health and Population) with the support of PAHO/WHO (World Health Organization).
This work is essential for guiding the response and adapting active case finding strategies. It is important to emphasize that these figures reflect detected cases, not the actual burden of the disease.
Given the barriers to accessing care, insecurity and stigmatization, the actual number of people affected is probably higher.
What is the extent of the situation according to the WHO? Are we talking about an increase in cases or better detection?
At this stage, it is prudent to speak of an increase in detected cases, rather than necessarily an increase in transmission.
What recent reports reveal is above all the existence of a silent transmission that has persisted for several years and that was not captured by the surveillance system.
Two elements support this analysis.
First, the identification of advanced clinical forms, including in an adolescent, indicates a considerable delay between infection, detection and diagnosis — the incubation period of leprosy varies from three to five years on average, but can reach twenty years.
Secondly, the cases were primarily identified through community reporting and not through the routine surveillance system, suggesting gaps in passive detection.
Globally, 172,717 new cases of leprosy were reported in 2024 in 188 countries and territories.
The global trend is downward—a reduction of nearly 20% over the last decade—but the disease persists where poverty, structural weaknesses, and limited access to healthcare converge. Haiti, unfortunately, exhibits all of these factors.
What measures have already been put in place by the WHO and its partners? Are other actions planned?
The Ministry of Public Health and Population, with the support of PAHO/WHO, deployed an integrated response in accordance with WHO normative guidelines.
This answer has several parts.
First, the supply of drug for multi-drug chemotherapy (MDT) in standardized blister packs including rifampicin, clofazimine and dapsone, packaged in four-week cycles, with separate presentations for adults and children covering paucibacillary (six months) and multibacillary (twelve months) forms.
The quantities delivered cover the identified cases and the additional cases anticipated.
Secondly, technical support for the safe delivery of treatments, clinical monitoring of patients, prevention of disabilities and strengthening of therapeutic adherence.
Third, strengthening contact tracing and follow-up, community interventions aimed at reducing stigma and promoting early access to care, as well as support for epidemiological surveillance and operational planning.
These activities are coordinated by a PAHO national consultant, an expert in neglected tropical diseases, in conjunction with departmental epidemiologists and under the supervision of a senior public health specialist.
Among the next steps, we are considering intensifying active case finding in at-risk areas, strengthening diagnostic capacity at the departmental level, assessing the relevance of post-exposure prophylaxis with a single dose of rifampicin for eligible contacts, in accordance with WHO recommendations, and developing community awareness campaigns.
Leprosy has been present in Haiti for several years. What factors could explain the recent appearance of new cases?
Several converging factors contribute to explaining this situation.
The weakening of the health system is the primary factor. The widespread insecurity plaguing Haiti has reduced access to health services in many areas, limiting the capacity for screening and monitoring slow-transmitting diseases such as leprosy.
When the surveillance system is weakened, cases silently accumulate.
Massive population movements constitute a second factor.
With over 1.4 million displaced people, overcrowding in reception sites, combined with loss of continuity of care, can promote transmission and delay diagnosis.
Socio-cultural barriers play a major role.
Some close contacts of confirmed cases are reluctant to seek medical help due to beliefs related to the disease.
The stigma associated with leprosy prevents affected individuals from seeking diagnosis and treatment.
Finally, the very nature of the disease contributes to this situation. With an incubation period that can last up to twenty years, leprosy can circulate for many years before the first clinical cases become visible.
The cases detected today reflect infections acquired several years ago.
In which departments or municipalities is the situation most worrying?
Two departments are currently affected.
The Artibonite department, historically recognized as the main leprosy hotspot in Haiti, concentrates the majority of cases with eighteen patients under treatment and five new cases confirmed in 2026 in the communes of Saint-Marc and Gonaïves.
The Southeast department, in the commune of Marigot, also reported two laboratory-confirmed cases.
The emergence of cases in the Southeast, a department where the disease was poorly documented, is particularly significant.
It suggests that transmission is not limited to historical hotspots and reinforces the need to extend active surveillance to the entire territory.
The Artibonite department, historically recognized as the main leprosy hotspot in Haiti, concentrates the majority of cases with eighteen patients under treatment and five new cases confirmed in 2026 in the communes of Saint-Marc and Gonaïves.
It is important to remember that during the period 2000–2015, suspected cases were mainly referred around Léogâne, in the West department, which served as the national reference center.
The current disease mapping needs to be updated.
What are the main challenges facing health authorities in the fight against leprosy in Haiti?
The challenges are numerous and interconnected.
Access to healthcare is the primary challenge. Insecurity severely limits the ability of healthcare teams to conduct field missions, perform active case finding, and ensure patient follow-up.
Many areas remain difficult to access. Diagnostic capabilities are limited. Leprosy diagnosis relies primarily on clinical examination by trained personnel.
However, in Haiti, frontline health workers are not always trained to diagnose this disease, which leads to considerable delays.
Stigmatization remains a major obstacle.
Patients and contacts refuse to seek help for fear of social rejection.
Until this barrier is removed, detection efforts will remain incomplete. Continuity of treatment is fragile. PCT requires six to twelve months of regular follow-up. In a context of population displacement and instability, maintaining treatment adherence over this period represents a considerable operational challenge.
Competition from emergency health services is a final factor.
In a country simultaneously facing cholera, malaria, armed violence and mass displacement, leprosy — a chronic, slow-progressing disease — risks being relegated to the background.
Do the current conditions in the country — insecurity, displacement, difficulties of access — have an impact on surveillance and care?
Absolutely. Haiti is experiencing one of the most complex humanitarian and health crises in the Americas. This situation has a direct and profound impact on the fight against leprosy. Insecurity limits health teams' access to areas where the disease is potentially present.
Entire communities are difficult to access due to control by armed groups, hindering active case finding, patient monitoring, and the delivery of medications. The displacement of over 1.4 million people creates overcrowded conditions in reception centers, which can facilitate transmission and complicate longitudinal monitoring of patients already receiving treatment.
A patient who travels loses contact with their healthcare facility. It is precisely in this context that community reporting becomes so valuable.
In Saint-Marc, Gonaïves, and Marigot, it was citizens, religious leaders, and local stakeholders who raised the alarm. The community is doing what the formal system can no longer do alone in certain areas.
This momentum must be supported and strengthened.
Leprosy remains associated with many prejudices. What message would you like to send to the public?
The PAHO/WHO message is clear: leprosy is a curable disease, and those affected deserve the same respect, dignity, and access to care as any other patient.
Leprosy is a bacterial infection that is transmitted through respiratory droplets, and only after close and prolonged contact with an untreated person.
Leprosy cannot be contracted through casual contact: not by shaking hands, sharing a meal, or sitting next to a sick person. Leprosy is not a curse, it is not a punishment.
As soon as a patient begins treatment, they cease to be contagious. PCT kills 99.9% of bacteria from the very first doses. The real danger is not the disease itself, but the delayed diagnosis caused by fear and stigma.
Stigma drives patients into silence.
It delays medical attention, promotes transmission, and causes unnecessary suffering. Eliminating leprosy requires as much about changing attitudes as it does about medication.
We must not reject those infected, but rather support them in accessing healthcare. Reporting a suspected case is an act of solidarity, not denunciation.
Are leprosy treatments available in Haiti? Can patients access them free of charge?
Yes. Leprosy treatment — multidrug therapy (MDT) — is available in Haiti and provided free of charge.
Since 1995, PAHO, in coordination with WHO, has ensured uninterrupted access to PCT in the countries of the Americas. This treatment is provided free of charge thanks to a long-standing partnership with the Nippon Foundation (1995–2000), and subsequently with Novartis Laboratories (since 2000).
In January 2026, the WHO and Novartis renewed their memorandum of understanding for five more years (2026–2030), ensuring the continuity of global supply.
Over the past 25 years, more than 8.3 million people worldwide have been treated thanks to this partnership.
PAHO/WHO has already provided the necessary medications to the affected departments. No diagnosed patient should be left without treatment. Financial cost is never a barrier: treatment is completely free, everywhere in the world.
What signs should alert the population and prompt them to seek medical advice?
The signs that should lead a person to consult a health professional are as follows: Spots on the skin that are lighter or redder than the surrounding skin, with a loss of sensitivity — that is, the person does not feel touch, heat, or pain in that area.
This is the most frequent cardinal sign. Numbness or tingling in the hands or feet, which develops gradually. Visible thickening or swelling of the nerves, particularly at the elbow, wrist, or behind the ear.
Muscle weakness in the hands or feet, difficulty grasping objects, or clawing of the fingers. The simple rule to remember is this: any skin lesion that is painless and feels nothing should prompt a consultation. The earlier the diagnosis, the more effective the treatment and the less likely permanent disability is to occur.
We also encourage anyone who has been in close and prolonged contact with a confirmed case to get tested.
Contact tracing is a cornerstone of the elimination strategy.
By: Lucnise Duquereste
https://ayibopost.com/les-cas-de-lepres-se-multiplient-en-haiti/
PAR Lucnise Duquereste•June 8, 2026
Eighteen patients were receiving treatment for leprosy in Gonaïves in March. Since the beginning of this year, five cases of the disease have been confirmed in Artibonite. Two others have also been confirmed in Marigot.
Confirmed cases of leprosy are increasing in Haiti.
In March, eighteen patients were receiving treatment for the stigmatized disease in Gonaïves. Since the beginning of this year, five cases have been confirmed in Artibonite. Two cases have also been confirmed in Marigot, in the Southeast.
The available data on new cases remains limited, but it is concerning enough to mobilize the Ministry of Health and its partners.
For specialists, the recently detected cases do not necessarily mean that the disease is progressing further today.
They reveal above all a transmission that could have gone unnoticed for several years, in a context where access to care, health monitoring and screening have been weakened by the multiple crises the country is going through.
Leprosy, a chronic infectious disease caused by the bacterium Mycobacterium leprae and affecting mainly the skin and peripheral nerves, remains one of the most stigmatized diseases in the world.
This reality still leads some people to hide their symptoms or delay seeking medical advice, even though effective and free treatment can cure the disease and interrupt its transmission.
Haiti struggles to measure the extent of the population affected by this disease, which has been present since colonial times . An analysis conducted in 1996 showed that between 1977 and 1996, nearly 2,000 patients were recorded.
What is the true extent of the situation today? Which municipalities are affected and what challenges complicate the response?
To answer these questions, AyiboPost contacted, in writing, the WHO representative in Haiti, Dr. Oscar Barreneche, a physician specializing in public health and tropical infectious diseases.
Trained in public health and having held several positions in infectious disease control programs in Latin America and the Caribbean, Dr. Barreneche regularly speaks on issues of epidemiological surveillance and strengthening health systems.
AyiboPost: What is the current number of confirmed leprosy cases in Haiti? Do you have data on the profiles of those affected?
Dr. Oscar Barreneche: Field data collected in March 2026 reported eighteen patients under treatment in Gonaïves, five new confirmed cases since the beginning of the year in the Artibonite department, 1 case in Saint-Marc and four cases in Gonaïves, as well as two laboratory-confirmed cases in the commune of Marigot, Southeast department.
Among the identified cases, there is one adolescent with an advanced clinical form, suggesting an old and undetected transmission.
Detailed demographic data — distribution by age, sex, clinical form — are being consolidated by the MSPP (Ministry of Public Health and Population) with the support of PAHO/WHO (World Health Organization).
This work is essential for guiding the response and adapting active case finding strategies. It is important to emphasize that these figures reflect detected cases, not the actual burden of the disease.
Given the barriers to accessing care, insecurity and stigmatization, the actual number of people affected is probably higher.
What is the extent of the situation according to the WHO? Are we talking about an increase in cases or better detection?
At this stage, it is prudent to speak of an increase in detected cases, rather than necessarily an increase in transmission.
What recent reports reveal is above all the existence of a silent transmission that has persisted for several years and that was not captured by the surveillance system.
Two elements support this analysis.
First, the identification of advanced clinical forms, including in an adolescent, indicates a considerable delay between infection, detection and diagnosis — the incubation period of leprosy varies from three to five years on average, but can reach twenty years.
Secondly, the cases were primarily identified through community reporting and not through the routine surveillance system, suggesting gaps in passive detection.
Globally, 172,717 new cases of leprosy were reported in 2024 in 188 countries and territories.
The global trend is downward—a reduction of nearly 20% over the last decade—but the disease persists where poverty, structural weaknesses, and limited access to healthcare converge. Haiti, unfortunately, exhibits all of these factors.
What measures have already been put in place by the WHO and its partners? Are other actions planned?
The Ministry of Public Health and Population, with the support of PAHO/WHO, deployed an integrated response in accordance with WHO normative guidelines.
This answer has several parts.
First, the supply of drug for multi-drug chemotherapy (MDT) in standardized blister packs including rifampicin, clofazimine and dapsone, packaged in four-week cycles, with separate presentations for adults and children covering paucibacillary (six months) and multibacillary (twelve months) forms.
The quantities delivered cover the identified cases and the additional cases anticipated.
Secondly, technical support for the safe delivery of treatments, clinical monitoring of patients, prevention of disabilities and strengthening of therapeutic adherence.
Third, strengthening contact tracing and follow-up, community interventions aimed at reducing stigma and promoting early access to care, as well as support for epidemiological surveillance and operational planning.
These activities are coordinated by a PAHO national consultant, an expert in neglected tropical diseases, in conjunction with departmental epidemiologists and under the supervision of a senior public health specialist.
Among the next steps, we are considering intensifying active case finding in at-risk areas, strengthening diagnostic capacity at the departmental level, assessing the relevance of post-exposure prophylaxis with a single dose of rifampicin for eligible contacts, in accordance with WHO recommendations, and developing community awareness campaigns.
Leprosy has been present in Haiti for several years. What factors could explain the recent appearance of new cases?
Several converging factors contribute to explaining this situation.
The weakening of the health system is the primary factor. The widespread insecurity plaguing Haiti has reduced access to health services in many areas, limiting the capacity for screening and monitoring slow-transmitting diseases such as leprosy.
When the surveillance system is weakened, cases silently accumulate.
Massive population movements constitute a second factor.
With over 1.4 million displaced people, overcrowding in reception sites, combined with loss of continuity of care, can promote transmission and delay diagnosis.
Socio-cultural barriers play a major role.
Some close contacts of confirmed cases are reluctant to seek medical help due to beliefs related to the disease.
The stigma associated with leprosy prevents affected individuals from seeking diagnosis and treatment.
Finally, the very nature of the disease contributes to this situation. With an incubation period that can last up to twenty years, leprosy can circulate for many years before the first clinical cases become visible.
The cases detected today reflect infections acquired several years ago.
In which departments or municipalities is the situation most worrying?
Two departments are currently affected.
The Artibonite department, historically recognized as the main leprosy hotspot in Haiti, concentrates the majority of cases with eighteen patients under treatment and five new cases confirmed in 2026 in the communes of Saint-Marc and Gonaïves.
The Southeast department, in the commune of Marigot, also reported two laboratory-confirmed cases.
The emergence of cases in the Southeast, a department where the disease was poorly documented, is particularly significant.
It suggests that transmission is not limited to historical hotspots and reinforces the need to extend active surveillance to the entire territory.
The Artibonite department, historically recognized as the main leprosy hotspot in Haiti, concentrates the majority of cases with eighteen patients under treatment and five new cases confirmed in 2026 in the communes of Saint-Marc and Gonaïves.
It is important to remember that during the period 2000–2015, suspected cases were mainly referred around Léogâne, in the West department, which served as the national reference center.
The current disease mapping needs to be updated.
What are the main challenges facing health authorities in the fight against leprosy in Haiti?
The challenges are numerous and interconnected.
Access to healthcare is the primary challenge. Insecurity severely limits the ability of healthcare teams to conduct field missions, perform active case finding, and ensure patient follow-up.
Many areas remain difficult to access. Diagnostic capabilities are limited. Leprosy diagnosis relies primarily on clinical examination by trained personnel.
However, in Haiti, frontline health workers are not always trained to diagnose this disease, which leads to considerable delays.
Stigmatization remains a major obstacle.
Patients and contacts refuse to seek help for fear of social rejection.
Until this barrier is removed, detection efforts will remain incomplete. Continuity of treatment is fragile. PCT requires six to twelve months of regular follow-up. In a context of population displacement and instability, maintaining treatment adherence over this period represents a considerable operational challenge.
Competition from emergency health services is a final factor.
In a country simultaneously facing cholera, malaria, armed violence and mass displacement, leprosy — a chronic, slow-progressing disease — risks being relegated to the background.
Do the current conditions in the country — insecurity, displacement, difficulties of access — have an impact on surveillance and care?
Absolutely. Haiti is experiencing one of the most complex humanitarian and health crises in the Americas. This situation has a direct and profound impact on the fight against leprosy. Insecurity limits health teams' access to areas where the disease is potentially present.
Entire communities are difficult to access due to control by armed groups, hindering active case finding, patient monitoring, and the delivery of medications. The displacement of over 1.4 million people creates overcrowded conditions in reception centers, which can facilitate transmission and complicate longitudinal monitoring of patients already receiving treatment.
A patient who travels loses contact with their healthcare facility. It is precisely in this context that community reporting becomes so valuable.
In Saint-Marc, Gonaïves, and Marigot, it was citizens, religious leaders, and local stakeholders who raised the alarm. The community is doing what the formal system can no longer do alone in certain areas.
This momentum must be supported and strengthened.
Leprosy remains associated with many prejudices. What message would you like to send to the public?
The PAHO/WHO message is clear: leprosy is a curable disease, and those affected deserve the same respect, dignity, and access to care as any other patient.
Leprosy is a bacterial infection that is transmitted through respiratory droplets, and only after close and prolonged contact with an untreated person.
Leprosy cannot be contracted through casual contact: not by shaking hands, sharing a meal, or sitting next to a sick person. Leprosy is not a curse, it is not a punishment.
As soon as a patient begins treatment, they cease to be contagious. PCT kills 99.9% of bacteria from the very first doses. The real danger is not the disease itself, but the delayed diagnosis caused by fear and stigma.
Stigma drives patients into silence.
It delays medical attention, promotes transmission, and causes unnecessary suffering. Eliminating leprosy requires as much about changing attitudes as it does about medication.
We must not reject those infected, but rather support them in accessing healthcare. Reporting a suspected case is an act of solidarity, not denunciation.
Are leprosy treatments available in Haiti? Can patients access them free of charge?
Yes. Leprosy treatment — multidrug therapy (MDT) — is available in Haiti and provided free of charge.
Since 1995, PAHO, in coordination with WHO, has ensured uninterrupted access to PCT in the countries of the Americas. This treatment is provided free of charge thanks to a long-standing partnership with the Nippon Foundation (1995–2000), and subsequently with Novartis Laboratories (since 2000).
In January 2026, the WHO and Novartis renewed their memorandum of understanding for five more years (2026–2030), ensuring the continuity of global supply.
Over the past 25 years, more than 8.3 million people worldwide have been treated thanks to this partnership.
PAHO/WHO has already provided the necessary medications to the affected departments. No diagnosed patient should be left without treatment. Financial cost is never a barrier: treatment is completely free, everywhere in the world.
What signs should alert the population and prompt them to seek medical advice?
The signs that should lead a person to consult a health professional are as follows: Spots on the skin that are lighter or redder than the surrounding skin, with a loss of sensitivity — that is, the person does not feel touch, heat, or pain in that area.
This is the most frequent cardinal sign. Numbness or tingling in the hands or feet, which develops gradually. Visible thickening or swelling of the nerves, particularly at the elbow, wrist, or behind the ear.
Muscle weakness in the hands or feet, difficulty grasping objects, or clawing of the fingers. The simple rule to remember is this: any skin lesion that is painless and feels nothing should prompt a consultation. The earlier the diagnosis, the more effective the treatment and the less likely permanent disability is to occur.
We also encourage anyone who has been in close and prolonged contact with a confirmed case to get tested.
Contact tracing is a cornerstone of the elimination strategy.
By: Lucnise Duquereste
https://ayibopost.com/les-cas-de-lepres-se-multiplient-en-haiti/