NEGLECTED BODIES AND STIGMATIZED TERRITORIES: THE BIOPOLITICS OF LEPROSY IN THE BRAZILIAN SEMIARID THROUGH THE LENS OF SOCIAL VULNERABILITY

Leprosy remains a persistent public health issue in Brazil, particularly in the Semiarid region, where its persistence reflects not only biological transmission but also structural inequality. Despite the availability of free multidrug therapy, the disease continues to affect socially vulnerable populations, revealing a paradox between therapeutic capacity and epidemiological persistence. This study aims to analyze leprosy in the Brazilian Semiarid as a biopolitically mediated phenomenon, shaped by territorial inequality, stigma, and limited access to care. An integrative literature review was conducted, including studies published between 2019 and 2026, selected through systematic search, screening, and critical appraisal procedures. The synthesis incorporated epidemiological, social, and health system perspectives to construct a comprehensive analytical framework. The results indicate that leprosy is spatially concentrated in vulnerable territories, where rural dispersion and limited health infrastructure hinder early diagnosis. High rates of physical disability at diagnosis reveal systemic delays, while failures in primary health care and contact surveillance sustain transmission. Stigma and institutional silence further contribute to delayed care and social exclusion. The discussion highlights that leprosy persistence is embedded in a nexus of vulnerability, where territory, access, and social conditions interact to produce unequal outcomes. Clinical cure does not eliminate the social consequences of the disease, reinforcing cycles of exclusion. It is concluded that leprosy in the Semiarid must be addressed as a form of social injustice. Effective control requires not only treatment, but also territorial equity, active surveillance, and policies aimed at social reintegration.