The Single-Dose Rifampicin Post-Exposure Prophylaxis (SDR-PEP) Demonstration Project is an innovative initiative designed to interrupt the transmission of leprosy in Nepal. Building on lessons from the Leprosy Post-Exposure Prophylaxis (LPEP) pilot (2015–2018), which showed strong feasibility and effectiveness, the demonstration project seeks to scale up preventive treatment across multiple provinces in partnership with the Government of Nepal.

While Nepal declared leprosy elimination as a public health problem at the national level in 2010, the continued detection of new cases signaled the need for additional strategies beyond multidrug therapy (MDT). SDR-PEP, recommended by the WHO Guidelines (2018), combines active case detection, contact screening, and preventive treatment, offering a proven method to reduce leprosy incidence and disability.

This project is being implemented in five leprosy-endemic districts across five provinces as a model of “stopping transmission.” It integrates retrospective coverage (contacts of patients diagnosed up to 10 years prior) with ongoing prospective case management. Activities include health worker training, community awareness, contact tracing, SDR administration, and periodic joint review meetings.

The objectives of the project are to:

• Demonstrate the effectiveness of SDR-PEP in reducing transmission.
• Provide evidence-based justification for national scale-up.
• Build partnerships between the government, /NGOs, and communities.
• Increase resource allocation and ownership at the federal, provincial, and municipal levels.

By demonstrating the feasibility of scaling SDR-PEP across diverse geographic and social contexts, this project strengthens Nepal’s roadmap toward a leprosy-free future, while reinforcing NLR Nepal’s role as a pioneer in innovation, research, and partnership for leprosy elimination.