Critically evaluate India's Programme for Prevention and Control of Leptospirosis (PPCL) in addressing state-specific and inter-state disparities in zoonotic disease burden.

Leptospirosis, a bacterial zoonosis spread through rodent urine contaminating soil and water, is tackled by the NCDC-run Programme for Prevention and Control of Leptospirosis (PPCL), now covering 12 States and 2 UTs across 181 districts [1]. Its record is one of solid diagnostic groundwork undermined by uneven state capacity.

Strengths in addressing disparities

• Endemic-state targeting: coverage of Gujarat, Kerala, Tamil Nadu, Maharashtra, Karnataka and the Andaman & Nicobar Islands, later widened to Uttar Pradesh, Assam, Odisha and West Bengal, corrects the early southern-coastal bias [1].
• Lab network: five dedicated laboratories across Kerala, Karnataka, Uttar Pradesh, Assam and Tamil Nadu take diagnostic capacity to weaker states [1].
• Capacity building: hands-on trainings, national clinical guidelines and assured drug-and-diagnostic supply standardise case management [1].
• Inter-sectoral coordination across health, veterinary and agriculture departments embeds a One Health logic [1].

Persistent gaps

• Reported burden tracks surveillance strength, not true incidence — over half of India's leptospirosis studies come from six southern states, leaving northern endemic pockets understudied [2]. Kerala's high case count reflects aggressive logging; silence elsewhere may mean blindness, not safety.
• Environmental surveillance is the least explored domain of zoonoses in India, so rodent-reservoir and water-interface data guiding state-specific action are thin [2].
• Diagnosis leans on the microscopic agglutination test, with sparse molecular detection, limiting early case capture in low-capacity districts [2].
• Weak disaster convergence: after the 2018 Kerala floods, 641 per 100,000 flood-exposed persons were infected, against a global baseline near 15 per 100,000 — PPCL lacks a flood-triggered prophylaxis protocol [3].
• Occupational focus is thin for paddy, livestock and farm workers who bear the burden [3].

PPCL has built the scaffolding of a national zoonoses programme but still measures where it can see rather than where disease is. Converging it with IDSP-linked sentinel expansion, molecular diagnostics, environmental surveillance and a disaster-triggered chemoprophylaxis protocol under a formal One Health committee [2] would turn uneven reporting into equitable protection — advancing SDG-3's promise of health security for the last worker in the field.