2021-12-31-accounts

2021

Annual Report

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN – ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

LEPROSY DEFEATED, LIVES TRANSFORMED

The Leprosy Mission England and Wales Registered charily no, 1050327 A company limited by guarantee in England and Wale5 no. 3140347 PRESIDENTS ANDVICE PRESIDENTS President - Vacant Vice President - Rt Revd. Donald Allisler The Leprosymission England, Wales and the Jsle ofman Vice President - Mrs Pam Rhode5 MEMBERS OFTHE BOARD OFTRUSTEES Vice President - Baroness Caroline Cox Mr A R Lancaster, Chair Vice President - Stefanie Reid MBE IDecernber 20211 Mrs A C Fendick, Vice-chdir Mr P J Wa150n, Ticasurer Mr H Ansley Profes50T Z Baklrlzief da Silva Perelra CHIEF EXECUTIVE OFFICER Mr Peter Waddup The Leprosy Mission England, Wales and the Isle ol Man Mr T Brooks AUDITORS Mr P Craig Mr R GidooTnal CBE J W Hlnk¥ LLP, 19 Highlield Road, Edgbaslon. Birmingham, B15 3BH Mr P C Halliday MTS M Jellema BANKERS Barclays Bank Plc, Pelerborough Buslness Centre PO ox 294 - 1 Church Styeet, Pelerborough PEI IEX CCIA Investment, Management Ltd, 80 Cheapside. London, EC2V 6DZ Mr R C Trrner Mr E Walker Mrs D E White Cafcash Ltd, Kings Hlll, West Malling, Kent ME19 4TD Santandey, Bootle, Merseyside L30 4GB The Leprosy Mission Isle of Man DIRECTORS Mr Paul Halliday. Chair Mr Graeme Easton. Treasurer Mrs Eleanor Duchars Mr Ralph TuTner Mr Peter Waddup

Report of the Trustees for the year ended 31 December 2021 The tTUStees, who are also directors of the charity for the purposes of the Companies Act, have pleasure in presenting their annual report and audited financial statements lor the year ended 31 December 2021. The accounts have been prepared In accordance with the accounting pollcy Set out in note I to the accounts and comply with.. the charity's Tegislralion the Companies Act 2006 the Charities Act 2011 The Charity Comrnission's Statement of Recommended Practlce ISORPI, Accounting and Reporting by Charities, effective January 2019 (second edition October 20191. good practice guidance on meeting the reporting requirernents, in section 13 01 the Charities IProieclion and Social Inveslmenil Act 2016, which came into force lor accounting periods beglnning on or afteT I November 2016. Glossary of terms and acronyms ADT JOA Jersey Overseas Aid Lymphatic Filariasi5 L-PRF Leukocyte Plallet Rich Fibrin LRI Leprosy Research Initiallve Multidrug Therapy Non-Governrnenlal Organisalion NIHR National Institute for Health Research Alliance Development Trust Activating and Engaging the People APPG All Party ParliarnentaTy Group BMC Bio-medical Central LF AEP MDT BOND UK network of NGOS working on international development Comrnunity-Ba5ed Rehabilitation Conference of the Parties MGO CBR cop NTD Neglected Tropical ￿'SeaSe OPAL 0rgani5ation of People Affected by Leprosy RIGHT Research and Innovation foT Global Health Transformation DSL Designated Safeguarding Leader FCDO Foreign, Commonwealth, and Development Office FOUND Fuelling Opportunities to end Unemployment for Nepalis With Disabilities GDPR General Data Protection Regulation GOADC Guernsey Oversea5 Aid Development Commisslon SORP Statement of Recommended Practices by the Charities Commission TLM The Leprosy Mission TLMEW The Leprosy Mission England and Wales The Leprosy Mission International UNCRPD United Nations Convention on the Rights of Persons with Disabilities ILEP International Fecleratlon of Anti-Leprosy Associations

Contents 07,..- hallenges ge from the air of the Board of TNstees pact re Plans We Are 57_-. e We Work Maklng Pollcy Values cial Summary trategy endent Auditors. Report and Financial Statements LEFT. M14RIA IN CABO DELGADO. MOZAMBIOUE HAS BEEN TREATED FOR LEPROSY. SHE HA5 BEEN TRAINED IN 5LISTAINABLE FARMING PRACTICES TO INCREASE TrESILIENCE TO CLIMATE CHANCIE Pl logrdL)hy O Fabelia M0171r

Photography @Ala Kheir ,hlMI

What is Leprosy. Leprosy is a disease caused by the bacteria Mycobacterium Leprae and Mycobacterium Lepromalosis.11 is mildly Inleclious, believed lo be transmitted predominantly by droplet infection alter being in close proximity with infecied individuals for prolonged periods. sometimes forcing ampulalion. FurthermoTe, leprosy damages nerves in the lace, causing blindness due lo people's inability to blink. Contrary lo popular belief. lepyosy remains a prominent global health issue In the 21st century. Recognised as an official Neglected Tropical Disease INTDI by the World Health Organization, 202.256 new cases were Tecorded In 2019 in 161 countries, 14.893 01 whom were children under the age ol IS. The disease doe5 not discriminate between race, age, gender. or nationallly. However, il rernains most prevalent in the poorest and most marginalised communities In the world where there is high population density, poor nulyilion. and poor housing. Leprosy has been curable since rhe early 1980s. Multidrug therapy IMDTI la six-to-12-monlh course of various anribioticsl has been adminisrered lo over 16 million people affected by leprosy since ils Inlroduciion. However, millions now live wilh irreversible impairment and disability. Unsurprisingly. oslracisation and phy51cal impaiyment are often accompanied by Ihe declining mental health ol people affected by leprosy. Leprosy has blighted humanl(ind loy millennia. Descriptions of the disease appear in ancient literature worldwide. Many ol these writings detail how affected people have been pushed away from their communitie5 and families. Devastatingly. due to ignorance, the ostracisation ol people affected by leprosy persists to this day, Fearing stigma and rejection, many people hide the early signs ol leprosy rather than seeking rnedical attention. 11 is tragic that a treatable illness can continue lo cause such devastation in the modern world. With your support. The Leprosy Mission ITLMI believes that leprosy, and all the suffering it brings. can be eradicated and confi'ned to the history books within our lifetime. Untreated leprosy is the cause ol life- changing disability and severe physical suffering for many thousands ol people worldwide. The disease damages the skin and nerve5 which can lead to the inability to feel pain. This often results in injury and chronic ulceration.

Message from the Chair of the Board of Trustees Another year has come and gone. and what a year il wasp As our pyogyammes were battered by wave after wave of COVID-19 and rocked by political instability. your generosity kept our mission afloat and fi.lled our hearts wilh hope. Your compassion allowed us lo provide vital support to those affected by leprosy. relieving them of the unimaginable slignia and suffering they endure on a daily basis. Together, we have successfully navigated a turbulent, deeply unceTlain 2021. 1 have never been prouder lo be a parl of The Leprosy Mission as l am today, or moye gyaleful lo have you walking with us. Without YOUT gills and Prayers, none ol thi5 would have been possible. O In India, the eonslruclion ol new surgical l&cililies In Chandkhuri Leprosy Hospital. including opeTation Ihealre, surgical ward, and intensive care unit, has PTogTe55ed significantly. and is due lo be completed by summer 2022. O ISO patient mediclne vendors, traditional healers and conimunily volunteers have been sensitlsed and trained in Nigeria. They have identihed 162 new cases ol leprosy. O S63 children and young people affected by leprosy received menlal health support from our Open Minds pyojecl in Nigeria. All year, our staff and partner5 Stood in solidarity wilh ihose we serve, risking their lives and health amidst conflict and oulbreaks of COVID-19. The Leprosy Mission England and Wales has continued lo aid the pandemic Tesponges in the countries where we work. Your support has provided oxygen cylinders, venlilatoys. and oximelers to TLM partner. Mawlamyine ChY15tian Leprosy Hospital in Myanmar. and funded the creation ol designated COVID-19 waTds in Chandkhuri Hospital in India and Anandaban Leprosy Hospital in Nepal. These are but a lew ol the highlights 012021. However, these are not just hgures. behind every number Is a person and their family whose lives have been changed thanks lo your SUPPOTI. From the heart, I want lo thank each and every one who has given so generously in 2021. You are payl of the TLM family, part ol this joint mission to defeat leprosy and translarm lives. I pray that you all will be ble55ed this corning year. Whatever 2022 might have in store for us, I know we will lace it togethey with love, courage, and compassion. Your kindness, alongside the dedication ol our partners and staff. has brought about the following successes. O By training female healthcare worker5 and 1,400 volunteer5 over the past lew years, we have empowered women to come forward for treatment despite the stigma they face In 2021. more women benehtled from our HEAL Nepal project than men. The project trained 118 medical staff. undertook 57 reconstructive surgeries. and administered ulcer trearment lo 233 people afFected by leprosy. Andy Lancaster. Chair of the Board of Trustees O Through our FOUND project in Nepal. 272 disabled people secured decent work.

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The Leprosy Mission

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Who we are ,• The Leprosy Mission England and Wales ITLMEWI is a global Christian organisation, leading the hght against leprosy. Leprosy Is concentrated in the PQOTest, most marginali5ed communities on our planet, Consequently, we work with people in 10 countrie5 in Alrica and Asia". Bangladesh, Ethiopia, India, Mozambique. Myanrnar, Nepal, Niger. Nigeria, Sri Lanka. and Sudan, These counlries all have high rates of leprosy or lack the servlces required by people who suffer from the dlsease. The flghi against leprosy Is a team effoTt. We paTlner with governments at all levels. non-governmental organisations INGOS), health service5, hospitals, businesses, trusts and loundalion5, churches and olher lailh groups. research inslitules, and universities lo end leprosy and Iransform lives. We exlsl to serve those affected by leprosy, Every project implemented, whether healthcare, Irainlng. or advocacy, is designed to optimally meet thelr n¢eds. We work closely with Organisations ol People Affected by Leprosy (OPALS) to amplify their voices on the world stage.

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NIGER SUDAN •4 NIGERIA ETHIOPIA

INDIA MYANMAR Where we work Taking our fight to the Human Rights Council Alice Cruz is the United Nalions Special Rapporle.UT lor people affeeled by leprosy. In June. shL) voiced her concern lo the Human Rights Council ovcy ihe drop in new lepr05y cases b<iing treoted because her111h workers styugglcd to reach cornmunities dijring lockdown8. Alice Sai￿ that people. affe.clcd by loprosy were all too often 'invisible and forgotten. "There is no building back better if states fail to put those who have been systematically pushed furthest behind at the centre of recovery efforts." Alice Cruz is the United Nations Special Rapporteur

Our Mission Following Jesus Christ. we seek to bring about transformation; breaking the chains of leprosy and empowering people to attain healing. dignity and life in all its fullness. Our Values COMPASSION: JUSTICE: As Jesus did, we care deeply lor others particularly those adversely affected by leprosy and those most in need. We feel their pain and are motivated lo walk alongside them in Christ-like love, dolng all we can lo support their physical spITilual and emotional wellbeing. We promote dignity. respecting and fosteTing human rights. We champion the implementation ol the UN Convention on the Rights ol Persons wrh Disabilities ICRPDI treaty and the PTinciples and Guidelines for the Ellmination ol Discrimination Against People Affected by Leprosy and their Family Members. We have appropriate rnechani5ms in place to actively protect children and vulnerable adults from harm and abuse. INTEGRITY: We work with honesty and transpaTency with a searnless correlation between OUT rnessage and our actions, We foster open communication. where there no feaT of sharing challenges and successes. We Yespect our partners and WOTk together to hnd solutions to problems and achieve common goals. HUMILITY: We treat everyone as equals and do not see ourselves as supenor to others. We seek to serve the m951 marginalised, who often live in difficult environments. We are willing to get our hands dirty as we serve others, just as Jesus was willing lo wash the feet of his disciples. We value the opinions of others and are open to listen and learn. We solicit and respond lo feedback from paTtners and those we serve. INCLUSION: We value all individuals. believing they were made in the image of God. We promote equal acces5 and opportunity lo all. and are committed lo removing discrimination and other barriers. enabling eo le to live life in all ils fullnoss.

PRIORIT151NG T141 IDENI IFICATION OF .L&PROSY IN WOMEN AND CHILDREN Dl"iotocJrdpkiy SWclYc?iJilldi Our Goals The purpose of The Leprosy Mlsslon 1$ to see leprosy deleated and live% tran$fornied. To achleve this. we warft towards the ambllious taTgets of Zero Leprosy Transmlssion, Zero L¢pr05y Disablllty and Zero i*prosy Dl$crlmlnation, ZERO LEPROSY DISABILITY We strive lo recknce the inadenee ol disability folbwing diagnosis, provide assislive devices and manage leprosy cornpllcations. In ths endeavour. we work alongside hDSPitats, community groups. and people affected by leprosy to supporl sell-care, Inner well-being, and to advocate for better quality treatment. ZERO LEPROSY TRANSMISSION Putting an end to leprosy tran5mi5sion remains our main prioTlty. In paylnership with governments, universities. and health seYvi¢e5. we use our expertise to co-develop Innovalive methods of early diagnosis. contact tracing. and effective treatment. We challenge rnyths about transmission to create supportive communities in which affected people can openly seek the medical attention they require. ZERO LEPROSY DISCRIMINATION Through awareness rai&ng and education carnpaigns, we seek lo replace stigrna with compassion. and end discrimination. WoTking in tandem with human right5 advocate5 and people who have lived experiences of leprosy. we challenge discriminatory laws and practices across the countries in which we operate. We also help to improve the living and working Conditions ol those we serve, to ensure theiT dignity and inclusion in society.

Our Strategy Through generous donatlons and prayer from ouy supptsrters. we at The Lepr05y Mlsslon England and Wales alm to make significant progress towards the followlng de$lYed out¢ome$ over the next three years: Towards Zero Leprosy Transmission Towards Zero Leprosy Disability O Our parlneis wlll have the hlgh-level leprosy expeTtlse needed lo suppor.t the h'nal mlle towurds Zero Leprosy. O Governmenis and civll society In our targeted endemic counlrles wlll be actlvily engaged In the Zero Leprosy agendu. O Our programmes will lead the battle for Zero LepY05y. Including the use ol fAlth.based and Cross-￿rD approaches. O The centres of excellence that we support will model good practise and new approaches in lepr05y compllcation management and rehabilitation. O GoveTnments and civil soclety In our taygeted endemic countries will be actively engaged in leprosy cornplication management and rehabilitation. O Our progyammes wlll improve the wellbeing of people affected by leprosy land other disabilities) and of their family members. KEY PERFORMANCE INDICATORS.. O The level ol leprosy expeylise of partners to supporl the strengthening of health systems wlthin the counlrles whlch we support. Q The number of target counlrles where our programmes are involved In health gyStem slrengthenlng for leprosy. O The number of projects we fund thai Implement cross-NTD approaches for detectlon and treatment. O The number of faith cornmunltles acilvely.engaged in leprosy awareness and detection. KEY PERFORMANCE INDICATORS: O The number ol leprosy cenlres that we support with improved facilities and services. O The number ot projects that we fund which implement cross-NTD or disability main5tYeaming approaches for complication management and Community-Based Rehabllitation ICBRI. O The number of projects that we fund which include sUPPOrt for inner wellbeing.

Towards Zero Leprosy Discrimination O People with lived experience of lepTOSy will drive advocacy on leprosy human rights issues. O Diseriminalory legislation will be repealed, and government policies and practices PTOtecl the righis ol people affected by lepr05y. O Increased income and dignih.ed employment lor people wilh lived experience ol leprosy and disability. KEY PERFORMANCE INDICATORS: O The level ol expertise within Oyqanisations of People Affected by Leprosy. lo run sustainable arganisations that can effectively advocate on leprosy issues. O The number of acts repealed or amended. O The number ol people beneh.ting from access to skills training and employment.

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Research and Innovation O We wtll develop a culture of innovatlon and learning, with every new PToject havlng an operational reseayeh component. O We, along with our partneTS, will have increased expertlse In operational and rnedlcal research. O We will develop strong Yesearch partnerships that result in the evidence and tools needed to achieve the Triple Zeros. O We will invest in leprosy research and the dissemination of leprosy knowledge and Skills. Funding and Policy Environment O We will develop greater awareness of leprosy in the UK and internationally. O We will deploy our vice presidents. ambassadors, and supporters to enhance the profile of leprosy and The Leprosy Misslon. O We will raise MPS and the Foreign. Commonwealth £* Development Office IFDCOS) awareness ol, and prioritisation of leprosy. O We will develop our partnerships with other stakeholdeTS lo achieve our slralegic priorities. Fundraising O We will drive a significant increase in strategically focused institutional funding. coordinated across The Leprosy Mission Global Fellowship. O We will support the fundraising capacity of our partners and other members of The Leprosy Mission Global Fellowship. O We will invest in new income stream5 to generate funding from research donors, through social impact investment, social enterprise funding. and high net worth individuals. O We will strategically align the work of our fundraising and programmes teams. O We will nurture and care for our supporteTS, enSUTing they feel close to the COTnmunities they are transforming. O We will allract and engage new individual donors, churches, corporations. and community groups. O We will develop a new website that oplimises the user experien￿. O We will increase the efficiency and effectiveness of fundraising initiative5 to increase SUPPOTt for overseas programmes.

Our People O We seek to excel in the following areas O Recruitment and management ol volunteers. O The safely and security ol our staff and partners. O Ensuring that we have, and that we communicate lo all staff and partners. robust safeguarding practices and policies. O We wll improve our attractiveness and retention rate as an employer, so we have the appropriately skllled and self-motivated staff needed to implement our strategy, O We will maximise the performance and potential ol our staff, O We will develop enhanced leadership and culture, with strong leader5 who make strategic decisions, model our values. and priorilise inner wellbeing. O We will ensure that we are partnered with strong organisations (both NGOS and Organisations of People Affected by Leprosy) which are well governed. and have the Capacity lo design, implement. monitor. and Yeporl on high quality leprosy pr¢)gYammes. ¢. Iwsi H15 pe li.

Our Challenges

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Working in conflict zones Violent conflict has tragically been a defi'ning feature of 2021. In many of the eounlries in which we operate. political inslabilily has prevented The Leprosy Mission England and Wales's implementing partners from carying out all planned activities. However. what has been achieved has been commendable under very challenging circumstances. Below are just some of the crises laced last year. headquarters were relocated tri the neighbouring region of NaTnpul& Coordinated lyom this new location, projects and heldwork largely continue to go ahead as planned in Cabo Delgado. with an added focus on security. Over the second hall o1202L Ethiopia was ravaged by a civll war between the Tigray People's LibeTation Front and government forces. TLM Ethiopia operates prirnayily in Amhar¥ a region in the north located near the epicentre of the violence. Homes have been raised io the ground, hospitals destroyed, and innumerable people have been forced lo flee the region. Our main programme has stalled as a result, and the focus wlll now be supporting a humanitarlan Yesponse to people affected by leprosy in the region. A coup in Myanmar in February and the rising up of the People's Defence Force led lo civil war, as the Military deployed arTllouTed vehicles across the cities in an allempl to silence the demonstrations in the ¢ounlYy. TLM Myanmar staff and the communitie5 they Serve were confined to home for many rnonths, for lear ot thely lives. This has had a signihcanl Impact on our ability to conduct our programme In Myanmar. The collapse ol the health system has also placed added strain on TLM'5 partner, Mawlamyine Christian LepTOSy Hospital, In Sudan, in October 2021, a mllitary oup took control ol the government, sparking violent clashes between civil protesters and the military. The Leprosy Mission clinic in Kharloum was forced lo close lor approximately two rnonlhs. HoweveT, despite lingering tensions. our partners courageously recommenced operations as soon as violence subsided in November, providing sale-haven and tTeatrnent lor those affected by leprosy. Operations in Mozamblque have been severely disrupted by conflict. Our partners have historically operated out ol an offi'ce in Pemb4 a city In the countrys northernmost Yeglon of Cabo Delgado. However. in April 202L conflict erupted in the re￿on between insurgents and Mozambique s security forces. Consequently. TLM Mozambique

The COVID-19 pandemic ANANDAgAN HOSPITAL BEtOMES.. A SPECIALIST'COVID CENTRE PR VIDING VACCINATIO PCRTESTS VENYILATO Phqtoqrap Lamlchha y @Sudip •'•• '• 'Oo f, •0 Ilc TDPGIOVE r+thiL'lQn

On top ol politleal instability. our operations have had to contend with relentless waves of the COVID-19 pandemic. Sporadic lockdown5 and tyavel bans have impeded our Staff's ability lo coordinate with our paTtners In our 10 Implementing countries. More recently. the rapid rise ol the Omicron variant saw nurnerous partners and members ol staff fall ill. Locally generated income for TLM hospitals has remained below pre- pandemie levels. as lewer non-leprosy patients have attended hospitals due io lear ol infection, In response, we have continued lo support partners in efforts lo care lor people affected by leprosy during the pandemic, providing additional funding wheye possible. In May 2021, Nepal became the heart ol the COVID-19 pandemic, recording the highest concentration worldwide. Hospitals were overrun by the surge ol new cases. In collaboration with the FDCO. we supported national health services through Ihe project HEAL Nepal by providing 9.19S vaccinations, a5 well as PCR lesls and venlilalors IOT treating people In isolation al Anandaban Hospital, Political instability and a chronic lack ol government funding have rendered health services In Myanmar woefully ill-equipped lo suppoyl paiients during the pandemic. Over the course 012021. we have equipped our partner hospital in Mawlarnyine with oxygen cylinders, ventilators. and oximeters. providing essential lifeline5 lor local cornmunilies. Programme5 In India came lo a slandslill In March 2021 following a second major outbreak ol COVID-19. The health system was brought lo Its knees as the country recorded approximately 300,000 cases per day, on average. In April. To control people's movement at the height ol the pandemic. the government designated region-5pecihc COVID-19 hospitals. This decision threatened to Isolate people arfected by leprosy from the expeYti5e that our partners provide al specialist health cenlres and also from access to COVID-19 trealmenl. In response. we funded TLM India E144.000 lo equip Chandkhuri Hospital with a designated COVID-19 ward. This allowed people affected by leprosy to continue accessing specialist Irearment at our hospital, whilst supporting the pandemic response. Overcorning these challenges has demanded crealivily. Travel bans have led to an increase in use of digital spaces to monitor projects and develop pyogrammes and capacity virtually. We believe that ihe technological expertise and the digital infTaslructuYe we have developed over the past two years will continue to irnprove the quality and efftciency ol OUT work lor many years lo come. In the face of adversity. the dedication. tenacity. and bravery of our partners and staff has allowed us to make signilicant strides towards our triple zero largel. The followng sections detail just sorne of the many highlights achieved in 2021.

Our impact on the ground

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Towards Zero Transmission HEAL Nepal- AGender Success Story Through the provision ol pyevenlalive and curative services. HEAL Nepal strive8 lo improve the heallh and well-being ol Nepalese people affected by lepTOSy and lymphatic hlariasis ILFI. Thi5 bold, multi-faceted project has six primary functions.. 3. To cyeale accessible sale spaces for people affected, helping Ihern lo generale a posilive self-image. 4. To update facilities al Anandaban Hospital. l. To raise awareness ol leprosy and LF in communilies across Nepal. 5. To increase Ihe provision of surgeries, lyeatmenis, and a5SiStive devices. 2. To improve the inlegralion ol case deleclion, treatment. and reporting services. 6. To provide COVID-19 health services at Anandaban Hospital. in support ol the national pandemic response. 41 Il -1 OMM Tilu ROA

In 2021. the COVID-19 pandemic seriously reslncled operations and oulreach efforts. Nonelhele5s, we are exciled to report that the project has achieved several impressive results. per cent) lor ihe hrst time in our prograrnmalic hislory. Leprosy awaTeness Cdmpaigns reached 1.26é,092 people12,884.768 In lotal since Heal Nepal began In 20191. The project has trained 118 medical staff. undertaken S7 reconslruclive surgeries, and administered ulcer treatment to 233 people affected by lepr05y. Addilionally. the project has OTganised sell-care training events. and pyovided treatment to 34 patients suffering from COVID-19. Perhaps the most ground-breaking achievement has been the gendered impact ol the project. Following ettoyls lo increase the engagement ol female health workers and community volunteers, more women IS9 per cenil have corne forward and received support than men141 J ((Il )I' Tom Bradle

Towards Zero Transmission Actlvating and Engaging the People (AEP) project. Bangladesh- Reaching the Unreached "Being a network of rellglous leaders from all main religions in Sri Lanka. we were called upon by ADT to support the Antl- Leprosy Campaign of the Ministry of Health to defeat Leprosy across the country. We are grateful for the opportunlty given to us as we have witnessed how many communlty members first heard about leprosy, the signs, symptoms. and cure. through our faith leaders. What's more, by working towards defeating leprosy, division between inter-religlous leaders has vlslbly reduced. and relatlonships strengthened. thereby promoting peace in the country." The AEP project seeks to ensuTe that people affected by leprosy receive all the relevant supporl they are entitled to. Working through leprosy hospitals and local sell-help groups, the AEP project has led lo the diagnosis of 437 new cases in 11 di51ricls over the last year. These eases we previously unknown and undisclosed. resulting in higher risk ol disability and community transmission. Early diagnosis ol these 'hidden cases. ha5 enabled access to prcsmpt IreatmenL contacl tracing, and helped prevent d15abilily. Crucially, 50.8 per cent of new cases idenlihed have been women Ivs 2020 global average 38.6 per cent). The higher Yalio of cases found among women reflects the empowering, gender sensitive nature of AEP inteivenlions. Mobilising Faiths Communities for a Leprosy Response, Srl Lanka - Uniting in Peace For the past lew years. we have been working in Sri Lanka through the Alliance Development Trust IADTI lo bring failh communities together and build peace. as they light the common enemy of leprosy. Religiou5 leader5 have received basic leprosy training and are now instTurnenlal In supporting the idenlilicalion ol new cases in their cornmunities. In 2021 lailh leaders moved from talking about lepr05y With their congregations to screening lor leprosy and raising community awareness. Last yeaT, in just one village nine new cases ol leprosy were found lout of 12 suspected case51. The positive social impact of the project was noted by inler-lailh leaders.. Mr Jayaweera Kohombange. Executive Secretary of the Inter Religious Peace Foundation. celebrating the unifying effects of a successful leprosy screening campaign, These efforts will be rolled out into many more villages in 2022.

VQI'.TINT TO PIl￿T FAAL ILIIVI? LHILPVS Strengthenlng Leprosy and Lymphatic Filarlasis Case-Finding in Nigerla - Flnd and Treat Effective case-finding is a key first step il we are win the fight against leprosy. Con5equenlly. We have supported our partneys lo work wth the Govemment to prornole efficient yet rigoious screening in the Kebbi and Sokoto regions of Nigeria. ISO medicine vendors. traditional healers and community volunteers have been sensilised and trained to identify and refer new cases. Three skin camps were conductecL identifying 162 new cases of leprosy. Moreover, 2021 witnessed the Teintroduclion of microscopy diagnosi5. in efforts to increase the accuracy of case-finding in Nigeria.

Towards Zero Disability Open Mlnds. Nigeria- Tackllng the Sllent Epidemic New Surgical Facilities in Chandkhuri Hospital. India - Cutting Edge Services Disabllity takes many forms. The marginalisation, physical impairment. and day-to-day sligrna caused by leprosy frequently accompany anxiety and depresslon. To combat this silent epidemlc, The Leprosy Mission England and Wales supports the Open Minds project in Nigeria, which provides counselling and mental health support to those affected by leprosy and other skin related NTDS. We believe that people attecled by leprosy are deserving of the fi.nest tyealmenl and care. A5 such, we are supporting Ihe construction ol new surgical facilities in Chandkhuri Hospital, complete with an operating theatre. surgical ward. and intensive care unit. These cutlin9- edge facilities will be used for reconstructive surgeries. ulcer surgeries, and eye treatment, amongst other services. Despite the pandemic, construction has progressed quickly over 2021, and 15 due lo be completed by summer 2022. In 2021. Open Minds took major strides forward. A mental health screening tool ha5 been translated into the local language. facilitating the diagnosis of anxiety and depression. People are also able to access eounselling support locally. Moreover, the prolect now pyovides a means lor people with severe mental health conditions. a¢ce5S to PTofessional psychiatrists. 563 children and young people were diagnosed with mental health difficulties, and received or were relerTed for support. New facilltles at Anandaban Hospital Despite being delayed by COVID-19 once again in 2021. construction ol the new hospital building al Anandaban is nearing completion New facilities will include a mother and child ward, an operdling IhealTe, dnd recovery rooms. THE VIEW FROM ANANOAOAN H PhotOgrap￿_ (4 abrina Dangol

Towards Zero Discrimination Fuelling Opportunitles to end Unemployment for Nepalis with Disabilities (FOUND) project. Nepal - Valuing Abllities Vocational Training Centres, West Bengal and Chhattlsgarh, India - Breaking the Cycle Vocational Training Centres play the esscnlial role ol preparing people affected by leprosy lor the labour market. Qualihcalions are necess(Iry lo ensure Ihal those whom we serve become credible job applicijnls Ihal can challenge social 51igrna and gain the level ol employment needed lo eaTn sufh"cienl income lo support themselve5 and their families. It is a means to break the cycle of poveTty. Discrimination often excludes people affected by leprosy and disability frorn the labour market. with catastrophic impacts on their economlc welfare, self-esteem, and sense ol independence. The FOUND project challenges stigma and improves mental health. demonstrating the abilities of disabled people. It pyovides acee5s lo dignified work opportunities for disabled people in Nepal and ha5 partnered with the Chamber ol Commerce to establish a Dlsability Confi'dent Employers, Movement, which we hope to scale up across Nepal. Unfortunately. this project was a victim of UKAid cuts. However, Ihrough the generou5 support of our partner. the Kirby Laing Foundation, we have been able to continue this lile-changing work. Tho pandemic threatened lo slop people affected lyom taking their exam5 in 2021, barring them from realising their ambitions and entering Ihe labour m¢irkel lor anoiher ye£ir. Consequenlly. on top ol our usual support lor this programme. we provided Vocational Training Centrcs In West Bengal and ChhaltisgaTh with new computers and internel connection. so people could complelc their exams remotely. In the context ol mass disruption due lo the pandemic, the project has enjoyed signiftcanl success in 2021. 272 disabled people secured decent paying work, and 92 per cenl ol people reported an increase in happiness and 5alisfaclion.

LEFT: LABORATOR Y TECHNICIAN IN AMGLADESH DOING TESTS FOR LEPROSY AND SCIENTIFIC RESEARCH Phorography C kabeha Monir Research and innovation Research forms the backbone of our Strategy. Our research pyogramrnes in 2021 have continued to help equip our partners with the necessary evidence to create innovative technical solutions to the challenges we face in achieving our triple zero largel. All research pyojects undertaken therefore work towards one or more ol our strategic priorilies. Zero Transmission. Zero Di5abilily, and Zero Discrirnination. Alongside Ihese priorilies, research 15 Qrganised into four separate arenas.. diagnoslics. reactions and neuritis. clinical, and social and Communily-Based Rehabililalion ICBRI. Research and Innovatlon for Global Health Transformation (RIGHT) Partnership AnolheT objective ol the project is lo evaluate the 'Replicable Model.: a model developed lor implementing a robust approach lo detection. treatment. and complication management within the government health system, which also seeks to actively engage people affected by leprosy. The model is funded by The Lepr05y Mission England and Wale5 and is supported by the local government in India. The data collected from this project will provide a baseline lo effectively plart develop, and evaluate a future research project, which will study an intervention that aims lo reduce the prevalence of disabilities in eyes. hands. and leet IhTough enhanced self-care. The study protocol lor this work has been finalised and approved by the ethics comrnitlee. Transforming the Treatment and Prevention of Leprosy and Buruli ulcer5 in Low and middl￿1nCorne Countries is (I project funded by the Nalional Institute lor Health Research INIHRI, and operates in three countries." Nigeria, Nepal and India. The project seeks lo expand our understanding ol the needs and treatments of palienls who have ulcers. By developing guidelines for Ministries of Health. leprosy centres and health centres, It aims to improve the self-care of people affected by leprosy who are al risk ol recurrent ulceration and disability. In 2021, we supported the implernentalion of related research studies in the Ihree implementing countrie5. as well as woyking closely in the UK wth our partner, the University of Birmingharn.

Studies in Nepal and Bangladesh The Leprosy Mission provides Core funding lo a wide range of ongoing research projects In Bangladesh and Nepal. All research partners share our v15ion to defeat lepr05y and transform lives. and all suppoyled projects are designed to equip us with the knowledge and tools lo turn our ambitious triple zero layget Into a Yealily. Below are some examples ol the many promising studies conducted throughout 2021. Strategic priorities: ZERO TRANSMISSION 11 ZERO DISABILITY ZERO DISCRIMINATION RESEARCH TITL RESEARCH TITLE Monitoring the effect of prophylactic Interventions in contacts of leprosy patlents including fleld-applicatlon of a novel immunodiagnostlc test in Bangladesh Pilot study on the use of autologou5 leukocytes and platelet rich tlbrln IL-PRF) In the treatment of trophic ulcers In patients at Anandaban Hospital in Nepal RESEARCH ARENAS RESEARCH ARENAS DiagnostlC5 and Clinical Cllnical RESEARCH TITLE RESEARCH TITLE Challenges In treatment of leprosy ulcers - A mixed method analysis of patient perspectives and treatment outcomes Molecular investigation of M Leprae in blood RESEARCH ARENAS Clinical RESEARCH ARENAS Clinical. Social & CBR PAGE 40- sfuDI£S IN NEPAL AND BANGLADESH

Th? research luridv.d by Tlie Leprosy Mission England and Wales culminate5 in an extensive range ol higli- quality publicatioiis every year. In 2021, examples included.. RESEARCH nTLE RESEARCH TITLE An individual randomised efficacy trial of autologous blood products, leukocyte and platelet-rlch fibrln (L-PRF), to promote ulcer healing In leprosy in Nepal: the TABLE trial protocol Bl¢x>d RNA signature RISK4LEP predicts leprosy years before clinical onset RESEARCH ARENAS Diagnostics JOURNAL OF PUBLICATION The Lancel.. eBiofvledicine - April 2021 RESEARCH ARENAS Clinical JOURNAL OF PUBLICATION Bio-medical Central18MCI - July 2021 RESEARCH TITLÉ Evaluation of a self- help intervention to promote the health and wellbeing of marginalised people Including those living with leprosy in Nepal: a prospective, observatlonal. cluster-based. cohort study with controls. RESEARCH TITLE An assessment of the reported impact of the COVID-19 pandemic on leprosy servlces using an online Survey of practitioners In leprosy referral centres RESEARCH ARENAS RESEARCH ARENAS Reactions & Neuritis and Clinical Clinical and Social & CBR JOURNAL OF PUBLICATION JOURNALOF PUBLICATION The Lancel. eBioMedicine - April 2021 Bio-medical Central (BMCI - May 2021 11 MFW ANNIJAI RF_POR T 2021 PAGIE 41

Advocacy on Climate and Neglected Tropical Diseases To lead an etfeelive ftghi againsl leprosy. governments across the globe need lo share our vision, In this endeavour. advocacy plays the crucial role of establishing links with governments lo influence policy. 11 aims to Yaise the pyoh'le ol leprosy as a global health problem in the UK and beyond, and ultimalely secure the rcsources and political willpower needed lo see an end to the disease. COP 26 and The Climate Emergency DRIN SURG NAN PIONEER AT TLM NÉW The prevalence of leprosy is inextricably linked lo environmental laclors, and these are going lo be exaeerbaled by the climate crisis. New cases of lepTOSy are heavily concentrated in the poorest regions of the world. Scientists worldwide now conftdenlly predict that these are the Tegions where temperature and humidity are sel lo rise most markedly. and extreme weather events are predicted lo Increase mosl drastically In frequency. Phologr aimale change therefore threatens lo undermine the signih.cant progress made towards achiewng OUT Triple Zero largel. Studies suggesr that periods ol high and prolonged hurnidily are correlated with noticeable increases in the rate ol bacterial transmission. Furthermore, the ever-increasing likelihood of drought and famine in our 10 partner counlries will negatively affect levels of malnutrition and hygiene (key determinants of leprosy severity and tyansmissibilily, due to their impact on the immune sysleml. All Party Parliamentary Group (APPG) on Malaria and Neglected Tropical Diseases (NTDS) In Novcynbor 2021. an APPG mp.t ViTtiJally lo discuss the rolc ol Brilish-backed sciericp in accclcraling tho ftghl against NTDS A panel of expeT15. inLluding Dr Indra Napit. surgeun aTid piuneer al TLM Nepal. sought to galvdnise cross- party parli£imentaYiari 5uppori lor continued British inveslment in NTD research and innovation. In the wake ol FCDO budget cul8. the slake8 ,1Te high lor our sector to persuade the government lo earmark the funding required to make signihcant progress towards ending NTDS and the disabilities tliey cause. Government budget cuts sparkod an industry-wide advocacy push through events such as the APPG. at which The Leprosy Mission look centre stage. These efforts to reinstate NTDS and leprosy as FCDO strategic priorities will continue into the new year. Consequently. as the eyes ol the world eagerly watched the era-dehning UN Climate Change Conference ICOP261 in Glasgow, The Leprosy Mission made its voice heard. Our Programmes and Advoeaey Oth'cer for Asia, Jarne5 Pender, participated In an event organised by the Bond International Development network. The event shone the spollighl on leprosy and disability by discussing a rights-based approach to disability-inclusive clirnate action.

Our People Ourvalues permeate the way we work, and staff are seen a5 part ol the TLM family. The Senior Management Team strive lo provide a collaborative and SUPPOTtive environment, where people are encouraged lo lulftl their potential. Each d(iy slarts with a time of prayer and devotion. w￿ch is an opportunity for Stall lo come togelher. worship God and 10 pray for each other ancl for those in need across the Global Fellowship. The well-being ol our staff. partners, and the people we serve is paramount. We take a 'zero-tolerance' approach the misuse of PDwer. and all forms ol abuse, harassment, or exploitation. To thig end, The Leprosy Mission England and Wales has de51gned Innovative safeguarding stTUCtures to protect the safety and dignity of everyone we work with. Rolling Out a Survivor- centred Approach to Safeguarding ways lo make environments more transparent. sale and supportive. Using resources developed by The Leprosy Mission England and Wale5, our parlners have been busy spreading safeguarding standards and knowledge. In Ethiopia. national DSL and Country Director Belelshachew Tadesse, led a full day ol safeguaTding training with 60 diheyenl disability OTganisations. In 2021. The Leprosy Mission England 3nd Wales coordinated Ihe implementation ol updated 'Bultying and Harassment. and 'Sateguarding ol Children and Vulnerable Adults protection policies. in tandem with The Leprosy Mission International and in-country partners, Firstly. implementation has involved tailoring policy changes to specihc social and cultural conlexls and developing extensive Safeguarding lyaining resource5. Secondly, all policies, training materials, and cornplainls mechanisms have been translated into local languages. The uptake of updated policies continues to be monitored ar the globaL national, and regional levels. In Nepal, extensive safeguarding tyalnlng took place as parl of the HEAL Nepal project. The national DSL used resources developed al The Leprosy Mission England and Wales to train fteld slaff, who in turn taught conimunity health volunteers. Alongside h.eld staff, these volunteers ottered safeguarding training to sell-help groups of people affected by leprosy in loc81 communities. educating them on their Tighls lo dignity and fair tTealment. The response at the community level was uplifting, with one group leader 5taling.' Our approach lo safeguarding pu15 the human rights of the survivor ftrsl. We promote a supportive, open environment where people can freely voice concerns. This en5ure5 that nobody in the organisation can ever be above accountability. "l •nJoy•d th• Ml•guardlnq elem•nt ol th• tralnlng b•¢auM I now reall8• that people ￿nTh9t do harni to Iho•e Affected by l•pvo•y. I It1￿w Wh￿ to do if Ihey do, and al SHG leader. l YAII en$ur¢ that all members, and other peopl• in the communlty, •lio know th1•." Collectlve leaming is key to constantly improving ouy ability to proteet our people with the utmost sensitivity and care. Once every three months. all designated safeguarding leads IDSLS) from all counlyies where TLM operates, meet virtually in a DSL forum to share their experiences. and discuss Self-help Group Leader.

Our Fundraising 11 h¢tcgrophy @Ka

Fundraising is core to eprosy Ission England and Wales. work. Without it. none of our field programmes would be possible. It is important to acknowledge our faithful individual supporters who have continued to donate despite facing their own challenges during the past year. Despite the tail end of the pandernic ¢ontlnuing to affect lundratslng activities, we saw record levels in income in 2021. The Uncondltional Appeal w35 granted a UK Aid Match, which raised £4.4 million in lotaL Includlng £2million from the UK government Iwhich will be received over the next 3 years). This. along with other campaigns resulted in over 9,000 new supporters across the year. Alatchlng your don8tlons wlth THE UNCONDITIONAL YI APPEAL UKaid Darne Darcey Bussell was Ihe voice of a Radio 4 Appeal for Mozambique, having visited communities affected by leprosy In the country. This raised almost £200,000 and was the most successful appeal in BBC Radio history. oto ' I,gulse nmmin The Leprosy Mission England and Wales was nominated foy five sector awards. winning Charity Times Fundraising Team of the Year. and Third Sector Digital Innovation Award.

Future Plans 2022

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Towar@s Zero. Leprosy TFahsmission. Disability. and Discrimination We are exclted announce a range of ambitlou$ progyammes lor 2022. deslgned to bring us ever closer to defeating leprosy and all the sufferlng It brlngs. These include. but are not Ilmlted to.. O Mission Zero. Sel to be launched in Mozambique. will promote a healthiey life ol dignity and wellbeing lor people affecled by leprosy. The project is ambitious and comprehensive. culling across all aspects of our programmes strategy. Its aims include,. Increasing the active participation ol people affected by lepr05y in econornic life and addressing climate change. It also plans to Increase The Leprosy Missions regional scope in Mozambique. expanding beyond Cabo Delgado to the province of Zarnbezia. This is possible because of your generous response to our Unconditional Appeal. wilh support from UKAid Aid Match funding. Raising awareness ol lepTOSy, encouraging people affected by leprosy to seek niedical help. O Project Khoj will commence operations in Nepal. in partneiship with TLM New Zealand and The Sl Francis Leprosy Guild. The pyoject will train comn)unity health volunteers to carry out active case ftnding and contact tracing activities, with suspected new cases of leprosy referred to local health facilities lor diagnosis and treatment. Improving access lo quality leprosy diagnosis. treatment, and prevention of disability services.

LEFTr. HUBS OF HOPE. 8ftINGING COMMUNITIES YQGEThERIN ' MOZAMBIOUE. Photcqiaphy Ricardo Franco O Emergency relief support will be provided to people affected by leprosy oind disability in South Wollo. in IhL Amhara region of Eihiopid. whose lives and livelihoods have been impaeled by the conflicl in the Tigray region. Furthermore. we plan lo work alongside TLM Elhiopia lo develop a new programme focused on SUPPC)Tling the government health system lo h"nd. diagnose and treat pooplo affected by leprosy, with a parlieular eTnphasis on children. Andhra Pradesh, India. REACH ME will have health system slrenglhening, Ihe right lo health, and advocticy al ils core. O Working with TLM Trus1 India we develop a Menlal Hcalth pyogramme in Bihar. India lo provide mental health services lo lepr05y-affecled commuiiilies. It will develop a model IOT lay and peer counselling which has the potential lo be replicated. This proiecl will have a signihcanl research component lo assess ils effectiveness. O Working through partney, Brighter Future Development Trust. we will implement a new project aimed at Zero Transmission in

Research and Advocacy O A Lepyosy Research Initiative ILRI- funded) project in Niger aim5 to develop and test the effectivenes5 of a leprosy stigrna-reduction intervention. This project will seek lo subvert negative peyceplions and behaviouys towards lepyosy patients among Nigerien health care workers. O As an outcome ol the NIHR funded RIGHT project, we will develop an evidenced-based sell-care guide lor governments. ￿rD Progyamme Managers and sell-care facililalors. which acts as a practical tool lo support best practice. O We will hold a side event al the Global "sabilily Summit to enable people disabled by leprosy lo have a voice on the global stage. calling for PTogrammes lo priorilise people-cenlred approaches. We will also make cornmilments lo ensure our programmes are even more diSab￿llY inclusive. O We will support The Leprosy Association of Sri Lanka to undertake a climate change and environmental risk assessment lo hnd out how Ils Members are being affected and ways to reduce their vulnerability to ils effect. People and Fundraising O Working closely wilh other Members ol the TLM Global Fellowship and ILEP. we will increase our locus on developing leprosy expertise. ensuTing TLM is equipped to lead initiatives that support the achievement of the Triple ZeTOS. This will include developing a Leprosy Competencies Framework and Standard Operating Procedures which will embed leprDSy capacily developrnent across all our country PTogrammes. This will be piloted by The Leprosy Mission England and Wales, TLM Nepal and TLM Nigeria. O Even though Iravel TeslTiclions have been widely lifted, we will continue to Use in-country photographers and hlmmakers, wherever possible and relevant. This is not only belley for the enviTonment, but in many case5 also removes cultural and language barriers. O We also plan to train TLM held Staff in each country lo improve their media skills. building capacity within SUPPOTled PTogTammes. Ultimately, our airn is to train and develop people affected by leprosy themselves lo be able to tell their own stories. O We will develop a staff working group lo champion the implementation of our environmental policy. helping us to make greater strides towards creation care. RIGHT-. ISABEL AND HER SON ANTONIO IN CABO OELGADO. MOZAM8laUE THIS IMAGE WAS PAR T OF A PHOTO STOR Y BY MOZAMBICAN PHOIOGRAPHER MARIQ MACILAU PUBLISHED ON THE TELEGRAPH'S WEBSITE IN JANUARY 2021 MARIO WAS 14 AND LIVING ON THF STREETS OF MAPUTO WHEN HE BQRRQWED A CAMERA FROM A FRI£NO AND FELL IN LOVF. WITH PHOTOGRAPHY O We ￿11 continue to prioritise digital fundraising, focussing on community and faith groups. Acquisition of new supporters is atso key. and we will be running tesl adverts on Sky television in autumn 20￿. Photography Q Mario Mdcilau

Structure and Governance Introduction Statement of the Trustees. Responsibilities Founded in 1874, The Leprosy Mission Englan Wale5. the Channel Islands and The Isle of Man (TLMEWCIIOMI is a charitable company limited by guarantee, A revised Memorandum and Article ol Association wa5 signed on 9 October 2005 and has not needed to be updated since signing. The charity number is 1050327.. the company number is 3140347, registered in England and Wales, The trustee5 Iwho are also directors of TLMEW lor the purposes of company lawl aye responslble for preparing the Trustees. Annual Report and the account5 in accordance with the law and United Kingdom Accounting Standards (United Kingdorn Generally AC￿pted Accounting Praclicel. The trustees who served in 2021 are listed on page l ol this report. Connected Charitles The law applicable lo charities in England and Wales requlres the trustees lo prepare accounts lor each financial year which give an honest, fair view of the affairs ol the charity and of the incoming resources and application of resources of the charity lor that yea¥. In preparing these accounts, the trustee5 have.. TLMEW is an aulonornous charitable company operating under a charter as a member of The Leprosy Mission's Global Fellowshlp, signed in 2011 by more than 30 international members and afh'liates. Proposed overseas projects that require funding are evaluated and approved by TLMEW as well as a working group of the Global Fellowship. supported by The Leprosy Mission Inlemalional ITLMII. TLMI 15 the secrdariat of the Global Fellowship, a connected charity with common values. O Selected suitable accounting policies and then applied them consistently. O Adhered lo the methods and principles in the Charities SORP. O Made reasonable and prudent judgements and estimates. In furtherance of the charity5 objectives. sorne grants were made lo overseas paylneys through TLMI, lolalling £3.781.35312020. £3,25L4221 Grants paid directly to overseas partners tolalled EL636,45712020.. £L13L6331. O Staled whether applicable UK Accounting Standards have been followed, subject lo any material departures disclosed and explained in their accounts. O Prepared the accounts on a going concern basis lunless it 15 inappropriate to presume that the charity will continue in operation). On 3 July 2018, The Leprosy Mission Isle of Man was incorporated as a company limited by guarantee, under the Companies Act$ 1931 to 2004 by the Department for Enterprise Isle ol Man. Since lorrnation, the charitable company has been a subsidiary ol TLMEW. O Kept suffi'cient accounting records that disclose with reasonable accuracy al any time the financial position ol the charity and enable il lo ensure that the accounts comply with the Charities Act 2011, the Charity (Accounts and Reportsl Regulations 2008 and the provisions of the trust deed. Funds raised by TLM Isle of Man in 2021 amounted to £48.31812020. £31.6681. O Safeguarded the assets of the charity. hence taking Tea50nable steps lor the prevention and deteclion of fraud and other irregularities.

Safeguarding We take safeguarding very seriously, with zero-tolerance lor any form of abuse. It has clear policies and procedures in place, based on The Leprosy Mission global policies which are iegularly Teviewed. These policies include.. O Safeguarding policy and procedures for protecting children and vulnerable adults. O Bullying and harassmenl policies and procedures. O Whistleblowing policy and procedures. O Recruilmenl and selection policy and proceduves. O Internal audit procedures. O Projecl development and approval documents. O Project monitoring and evaluatlon guideline5. O Risk rn8nagement policies and procedures. The Leprosy Mission eontlnues to contract an independent whistleblowing selvice, Safecall, which is accessible to all TLM Global Fellowship Members. including TLMEW, should anyone not want to use the internal reporting system In 2021.. O A new Safeguarding Advisor was appolnled to the Peterborough office. O Safeguarding remained a standing item on all SMT and Board meeting agenda5. Q The Safeguarding Advisor remained in consistent contact with the DSLS acTOSS our 10 implementing countries. O All members ol staff al TLMEW and TLM Trading Ltd la separatety Yegistsred company residing in our building) received compulsory safeguarding training. Details of the newly conlextualised Global Saleguaiding Policy and ProceduTes can be found in the Our lrnpacl, section of this report Inole page 431 under 'Our people.. In 2021. just one safeguardlng Incident was reported by our p8rtner5. Thls Incident wa5 repoyled to the Charities Commission in a timely fashion. Adhering lo due protocol. il was investigated by TLM International and an external consultant, The Charity Commission has closed the case with no additional actions needed. The ¢hair of the Board has overall governance responsibility for safeguardlng.

Reserves Policy The trustees, reserves policy continues lo maintain unreslricled funds (free reserves) thal are sufficient to provide TLMEW with enough working capital to carry on its existing activities successfully and develop new area5 of endeavour. We have designated funds which are set aside lor 5pecihc purposes, our policy does not include these designated funds. ol delayed and in some cases cancelled projects in 2021. we realise that there 15 an urgent need lo ftnd the undiagnosed cases caused by the pandemic leslimated at 160,0001. Our level ol free reserves will allow us to do that across the len countries where we work. OUY total reserves as 0131st December 2021 are made up as follows.. To ensure that we have the necessary funds in place to react to the growing and urgent needs across the Global Fellowship. the Iruslee5 have changed the criteria lo provide a range ol free reserves rather than a set hgure. The previous policy of holding free reserves lo meet three months. expenditure has been amended to holding free reserves to meet between three- and five-monlhs. expenditure. After a period Restricted funds £3,177 million Designated funds £2.925 million Free reserves £4,107 million

57 The free reserves as al 31 December are £340k above the maximum required of £3,781 million, this has occurred due to a record level of income in 2021 but delays and limitations in our ability to rernil during the previous 2 years due lo the global pandemic. However, thi5 will allow us lo commit a record remittance to lepTOSy projects during 2022 at a Iirne when il has never been needed more. Our level of free reserves dropped by £982k in January 2022 due lo the need for a high level of remittances to our implementing partner5. continue with this flagship project. This wa5 essential alter the UK government gave notice lo cease funding as a result ol the overseas aid cuts in July 2021. We also continued lo increase our legacy reserve by £200k to provide an insurance policy again51 this very unpredictable income stream in futUTe years. The charity 15 confident that il will meet the required pension contyibulions fTom ils projected income without significantly lrnpacling on planned charitable acliwlies. We continue lo calculate OLtr free reserves without setting aside designated reserves lor pension liabilities. Designated funds - In 2021 we created a new designated fund to protect funds from our free reserves foT the FOUND project to ensure we would be able to

Grants making Policy The Lepyosy Mission England and Wales is dedicated to ensuring that ils funds are used as efliciently as possible lo attain our strategic targets and improve the lives of those affected by lepr05y. who operate in a Yegion or community where they can deliver a specific service to affected people that would otherwise be neglected. Non-TLM partners are particularly important in Srl Lanka, where there Is no TLM office. In 2021, we paid ES,417,81012020'. £4.383,OS51 in ¢)verseas grants. Our programmes are implemented by partners who embody our values,. many ol whom ale members ol the TLM Global Fellowship. This year, we collaborated with 37 partneys aeross our 10 implementing countries. as well as UK universities. The Leprosy Mission supports disabled people and other oslyacised groups, alongside those aftecled by leprosy, with the aim lo promote social inclusion Ithis includes working with those affected by other NTDS). The chart5 OPPOSite indicate the proportion of the programmes budget spent in each of our 10 countries, and the proportion of funds spent in each strategic area. Partner programmes are managed by national members of staff who deliver projects and services to people affected by lepr05y. At times. we work with oyganisalions outside ol The Global Fellowshlp

COVID-19 RESPONSE 8% OTHER 13% ZERO DISCRIMINATION 23% FUNOWG BY STRA GICAREA 59 ZERO DISABILITY 30% ZERO TRANSMISSION 24% SUDAN Ix SRI LANKA 2% INDIA 26% ETHIOPIA 4% NEPAL 53% BANGLADESH 4% NIGER 5% MYANMAR 6% NIGERIA 9% FUNDING BY COUNTRY MOZAMBIQUE lox

Financial Summary The lull statement ol financial activities follows, in the Independent Auditors. Report. Highlights include., O Total income from all sources in 2021 was É11.967,29512020 £9.989.4341 O Expenditure for direct charitable activity was £6.734.16L or 56 per cent ol lolal income12020.. £S.656,494 or 56 per cent). O Costs lor fundraising amounted 10 É2,340.633 in 202112020.. £2.024.1361. This provided a 511 per cent return on investment in terms ol fund5 generated. 74p in every pound was spent on ehaTilable activities. O Income from individual SUPPOTters rose from £2,921.032 in 2020 10 £4,125,482 in 2021, a miraculous 41 per cent increase. O Grants from Irusls. toundalions, corpcralions, and other OTganisalions continue lo be an important component of our fundraising income. amounting to £451,901 in 202112020. £203.0061. Significant donations weTe received from Haverslock Charitable Trust. The Kirby Laing Foundation and Sl Lazarus Charitable Foundation. O Income from government grants and instilulions. including Comic Relief, FCDO, Guernsey Oveygeas Aid and Development Commission, Irish Aid Ivia The Leprosy Mission Northern Ireland ITLMNIII, Jersey Overseas Aid, Tearfund, University ol Birmingham INIHRI lotalled El,383.011 in 2021 12020.. £1.279.3571. This represents 11.5 per cent of income in 202112020., 12.8 peT cent) O Revenue from legacies remains a signiheant portion ol total voluntary income al £4,188,438 or 35 per ¢ent12020.' E3.876,726 or 39 pei cent) O Community fundraising provided £679.071 in 2021 12020". £586,160), a 15.6 per cent increase on 2020.

61 O Off balance sheet income generated lor 2021 programmes with support from TLMEW for other members ol the TLM Global Fellowship lolalled approximately £345,180 JW Hlnks LLP acted as auditors lor The Leprosy Mi55i0n England and Wales. Signed on Behalf of the Trustees TLM Norlhem Ireland Activating and enga￿ng partnerships to reduce leprosy in Bangladesh Euro 70,0001£58.n51 (IRISH AIDI Andy Lancaster. Chair of the Board of Trustees TLM India IE85,7081, TLM Nepal 1£118.3271. TLM NigeYia1£2L1391. RtGFrri INIHRI TLM Myanmar. Access for Health 'On the Up and Up,, US$ 80.324 1£6L2911 IUNOPSI

Independent Auditors. Report and Financial Statements

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Charity Registration No. 1050327 Company Reglstratlon No, 031403471England and Wales) THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN ANNUAL REPORT AND FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN INDEPENDENT AUDITOR'S REPORT TO THE TRUSTEES OF THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN Opinion We hav8 audited the financial statemanls of The Leprosy Mission England, Wales, the Chann81 Islands and th8 Isle of Man Ilhe 'charily I for the year ended 31 December 2021 which eorllprise the slalemenl of financial activilies, the balance sheet, the statement of cash flows and Ihtr notes to the financial statements, including a summary ol significant accounting policies. The financial reporting framework that has been applied in their preparation is applicable law and United Kingdom Accounting Standards, including Financial Reporting Standard 102 The Financial Reporting Slandard applicable in Ihe UK and Republic of Ireland IUni18d Kingdoffl Generally Accepted Accounting Praclicel. In our oplnlon, the flnanclal stalemenls.. give a true and lair view ol Ihe slate ol the charilable company's affairs as al 31 December 2021 and ol ils incoming resources and application ol resource5, for the year then ended., have been properly prepared in accordance with United Kingijom Generally Accgplgd Accounting Practica; and have been ptypared in accordance with Ihe requirements of the Companles Act 2006. Ba8ls for oplnlon We Conducted our audit in accord8nce with International Standards on Auditing IUKI IISAS IUKII and applicable law. Our responslbllilles under Ih05e standards are further described in the Audllols responsibllltles for the gudtt of Ihe financial slalemenls section of our report. We are ind&pendenl of the charity in accordance with the ethical requirements that are ielevanl lo our audit of the financial slat8menls in thè UK, including the FRC'S Ethical Siandartj. and we have fulfilled our other elhlcal responsiblllli8s in accordance wlth these requirements. We believe that the audll gvidence we have oblaSned is sufficienl and appropriate lo provide a basis for our opinion. Con¢luslons relallng to golng concern In audlling the financial 81alemenls, we have conclu(led that the INslee8' use ol the going concern basis of accounting in tha proparalion of th8 financial slalemgnls is appropriate. 8ased on Ihe work we have performed, we have not idenllfied any material uncertainties relating lo events or conditions that, individually or colleclively. may cast signilieanl doubl on the charity's ability lo conlinue a8 8 going conc8rn for a period of al least twelve months from when the financial stal@menls ar@ aulhoris8d for issu8. Our responsibililies and the responsibllilles of the Truslees with respect lo going concern are described in the relevant sections of this report. other Infom)atlon The olh8r information comprises the information includ8d in the annual rèport other than the financial slalemenls and our auditor's report Ihereon. The Trustees are responsible for the other inforrnation coniained within the annual report. Our oplnion on the financial statements does not cover the other information and, except lo the extenl otherwise explicitly slated in our report. we do not express any form ol assurance conclusion Ihoreon. Our responsibility is lo read the other information and, in doing so, consider whether the other information 15 materially incon51s1ent with the financial slalemenls or our knowledge ot>lained in the course ol the audit. or otherwise appears lo be materially misslaled. If we identify such material inconsistencies or apparent material misslalements, we are required to determine whether this gives ￿se lo a material misslalemenl in the financial statements themselves. If, based on the work we have perfomied, we wnclude that there is 8 material misslalamenl of this other infomalion, we are required to feport Ih8t fact. We have nothing lo report in this regard.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN INDEPENDENT AUDITOR'S REPORT (CONTINUED) TO THE TRUSTEES OF THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN Oplnlons on other matters pre5crlbed by the Companies Act 2006 In OLJr opinion, based on the work undertaken in th8 course of our audit". the information given in the Iruslees. report, which includes the directors. report prepared for the purposes of company law, for the financial year for which th8 financial slalemenls are prepared is consislenl with the financial slalemenls.. and the directors. report included within the trustees, report has been prepared in accordance with applicable legal requirements. Matters on whlch we are requlr•d to report by exceptlon In the light of the knowledge and understanding of the charily and its environment obtained In the course of the 8udil, we have not identified mal8rial misslalemènls in the directors, report included within Ihe Iruslees, report. W8 have nothing to report in respect of the followlng mallers in relation lo whlch the Companies Act 2006 requires us to 18POrt lo you if, in our opinion., 8dequale accounting records hava not been kept, or returns adequ8le lor our audit havo not begn received from branches not visited by us., or the financial slalemenls are not in agreement with the accounting records and relurn$', or certain disclosures ol Truslegs, remuneration specified by law are not made., or we have not received all the information and explanations we require for our audit., or the Trustees were not enlilled lo prepare the financlal stalemonls in accordance with the small comp8nieB reglme and lak& advantage of the small cornpani8s' ex8mpllons In preparfng the Iruslèès. reporl and from the requirement lo prepare a slr8legie report. Résponslbilitl•8 of Trustegs As explain&d more fully in the Slalemenl of Trustees, Responsibilllles. the Trustees, Iwho are 81so the directors of the charitable company lor the purposes of company lawl, are responsible lor Iho prcparalion of the accounts and for being satisfied Ihal they give a true and lair view, and for such Internal control as the directors determine is necessary lo enable the preparation ol accounts Ihal are free from material misslatemenl, whelh8r due lo fraud or error. In preparing the accounts, the Trustees are rèsponsible for assessing the charlly's abillly lo continue as a going concem. disclosing, as applicable, mallers related lo going concgrn and using Ihe going concern basis of accounting unl8ss the Trustees either intend lo liqvida18 the company or lo cease operations, or have no realisli allernallve bul lo do so. Audltor's rosponslbllltle8 lor the audlt of tho financlo18tatements Our objectives are lo obtain reasonable assurance about whether the financial slalemgnls as a wholg affj free from material misstatement, whether due lo fraud or error, and lo issue an auditor's report that includes our opinion. Reasonable assurance is a high level of assurance bul is nol a guarantee that an audil conducted in accordance with ISAS IUKI will always detect a material misstatement when il exis15. Misslalemenls can arise from fraud or grror and are considered rnalerial if, individually or in the aggregate. they could reasonably be exp8cl8d lo Snnuence the econornic decisions of users laken on the basis of these financial slalemenls. A further description ol our responsibilities Is available Dn the Financial Reporting Council's website al.. hllps'.11 www.frc.org.L4klaudilorsresponsibililies. This doscriplion forms part of our auditor's report.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN INDEPENDENT AUDITOR'S REPORT (CONTINUED) TO THE TRUSTEES OF THE LEPROSY MISSION ENGLAND, WALES. THE CH'ANNEL ISLANDS AND THE ISLE OF MAN Ext•nt to whlch th• audlt wa• conild•r•d c•pabl• of d•t•dlng Irr•gularltlo•, Includlng frnurl Irregularities, including IrAud. are instances ol ncthcompliancg wrth law3 and regul•tion$. ￿ design procedures in lin8 with our re8ponslblllii•5, Qutlined above and on the Financi81 Raporting Counril's WEbslte, to delecl rnalerial ml¥¥lolernenl$ in r88pect ol itreguhriliei, Induding frbud. We oblaln and update our undèrstsndlng ol the entity. its activits'ol, its contr¢1 envlronm¢nt, and Ilkdy futur• developrnenl8, Indudlng In relalon io thè legal and r¢gulalory Iramework applicable and how the entlty S ccmplylng wlth that framework. eaied on this underÈtanding, we Identity and a$sai¥ the dski ol material mi4ilalem•nt ol the financlal $l&lemenl$, wh¢lh&r due lo fraud or error, de8ion and pèrform &udlt procedure8 reiponiive to th09e riik$, •nd obtain audit ewdenee that 1$ sufficianl and ¥ppropd•to to provlde & basil fr¥ our oplnlon. Thil incJude& cmdderatlon of th• riik ol acti by the enllly thal ￿re conlrary to app4iGab18 lawB and re9(￿ationS, induding fraud. In reJpon¥e tc the risk of Irwulèrits"e• 4nd nonrycomplianc8 Iwi$ ond r•gul•llon$, Including frwud, we de8ign•d procedure8 whith induded". Enquiry ol rnanag8ment and those tharggd wth govem•nce •round actual 4nd pot•nll41 Iltig¥llon •nd claims a$ well 31 actu&l. suspected and alleged IrBud., Rewewing minutes ol nx¢tlngs of IhoBe charged with governanu.. Asgesslng th• txtenl ol compliance with th• lawg Jnd regulauoni con9idar&d io have a direct matorf•l effect cn the flnancl41 $t8tement• or the operationi of the entlty thrtyjgh •nqulry and in¥p¢¢tlon,' Reviewino flnancial 8talement di8dosure4 and te6knng lo wpporting documentalion to A8iei8 compllanc8 wlh applicable lawB 8nd regulations,, Performlng audll work ovar Ihe risk ol managernent bi88 and override ol controls, including teJtlng ol loumal •ntri•$ and other adlu81menl$ for approprialenesB, evaluating the buiine91 raU￿ale ol iignificant trans8cbon$ outside ltte normal courie ol bu8in158 and Feviewing acc￿￿￿￿n9 ¢¥timates for Indicator8 of polenlal bi￿. Because of lh• inhor•nt limltalloni ol an audlt, there is a rl•k that WD wll not detect all irregul8ribe¥. including those188dlng to A material miB8tatement in tho financial Jlalem8nts or non-compjiance wlth regulallon. Thls rlsk incxe¥88s Ihe rnore that compliance wlth A law or ragul8lon ll removed from the evenlj and Imn54Ctioni réflaeted In th¢ fln8nDal slatemMi¥, 4• we be less likely to becom• aw&re ol inilance• of noTr compliance. Th• Mik ol not detecting 3 m•l•rial mi35l*ement r?sulkn'ng from fraud is higher than for one rn3ullj.ng from error, a8 l¥&ud may involve collu8ion. lorgery, Inlenlional orni88ions, rnisrepresentalions, cr the ov•rridÉ ol Intèrnal control. U•• of our rnport Thi6 report ia mAd8 gol•ly to the charltable cornpany's m¢mOers, al • body, in accordance Chapter 3 of Part 16 of the Companies Act 2008. Our Budit work hys been und&rtak&n so Ihal we mlghl statè lo thè charitable company's mem￿r3 tho%8 matters we are ￿qUIr0d 10 51ale to them in an au¢itor8' report and for no othor rpose. To the fullest 8Xt•nt pgrrnrtled by law, we do not #cLept or assum• respori8ibilily lo anyone other than the charitabl• company and the charitable company'8 members as 8 body. lor our audlt woth, for thls report, or for the ow'nlon5 we hav• formed. Polor Smlth ACA FCCA15•nlor Ststutory Audltor} For and tsn behalf of JW Hlnka LLP 19 Highfiebj Road Edgbaston 8irmingh 815 3BH Charterqd Atcountarrt# Statutory Audilor

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN STATEMENT OF FINANCIAL ACTIVITIES INCLUDING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 DECEMBER 2021 Current flnanclal year Unfostrlcted R•strlct•d lunds fund5 2021 2021 Total Total 2021 2020 Notes Donations and legacies Income from invgslments Other income 7,871,281 4.072,620 11.943.901 9,8S7,693 16,809 16.809 15.037 6,585 6,585 116.704 Total Incom• 7,894,675 4,072,620 11,967,295 9,989,434 Exp9ndilure on raisin9 funds 2,340.633 2.340,633 2,024,136 Expenditure on Gharilable acllvilie8 4,459,771 2,274.390 6,734,161 5.656,494 Total resourc•s •xpend•d 6.800,404 2,274,390 9,074,794 7,680,630 Nel gainslllossesl on investments 12 184,844 184,844 72 Net movemant In fund• 1,279,115 1,798,230 3,077.345 2,308.876 Fund balances at 1 January 2021 5,753,835 1,379,122 7,132,957 4,824,081 Fund balances at 310ec•mb•r 2021 7.032,950 3,177,352 10,210,302 7,132,957 Th8 slatemenl ol fin8nc1818clivili•s includes all gains and10s88s recognisgd in the year. AJI income and expenditure derive from continuing aclivilies. The statement of financial aciivllles also complSes wllh the requlrements for an Income and expenditure account under the Companies AGt 2006.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN STATEMENT OF FINANCIAL ACTIVITIES ICONTINUED) INCLUDING INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR ENDED 31 DECEMBER 2021 Prlor flnanclal year Unrestrlct•d Restrlcted funds funds 2020 2020 Total 2020 Not•8 Oonalions and legacies Income from investments Other income 6,924,555 2.933,138 9.857,693 15,037 15,037 116,704 116,704 Total Income 7.056,296 2,933,138 9,989.434 Expenditure on raising funds 2,024.136 2.024,136 Expenditure on charitsble acllvllle$ 3,049,398 2.607,096 5,656,494 Totol r•sourc•s oxpended 5,073,534 2,607,096 7,680.630 Nel g81nsll108sesl on inveslmènls 12 72 72 Net movgmgnt In lunds 1.982,834 326,042 2.308,876 Fund b81ances al 1 January 2020 3,771,001 1,053,080 4,824.081 Fund balances at 31 Decembor 2020 5,753,835 1,379,122 7,132,957 The $1818manl of flnan¢lal adlvilles includes all gains and losses recognls8d In the year. All income and 8xpendilure derlve from continuing aclivilies. The s181emenl of financial activllies also complies with the requirements for an income 8nd expenditure account under the Companies Act 2006.

THE LEPROSY MISSION ENGLAND, WALES. THE CHANNEL ISLANDS AND THE ISLE OF MAN BALANCE SHEET AS AT 31 DECEMBER 2021 2021 2020 Not•9 Flx•d asset• Tangible assets Inv8$tmonls 14 15 412,770 670,891 456,179 485,847 1.083.461 942,028 Curr•nt a8•qt• Debtors CBsh at bank and In hand 17 1.406,785 8.033,458 1,405,562 5.064,475 9,440.243 6,470,037 Cr•dllori: *mount¥ falllng du• wlthln on• yur 1313,4021 {279,1061 Net ¢urr8nl a888ts 9,128,841 8,190.931 Total M¥el•1•8J eurr•nt Il•bllltl•• 10,210,302 7.132,957 IDcom• fund• Reslrfcted lurKI8 21 3,177.352 1.379,122 D8signalod lunds Gen8ral unr8strfcled fund8 20 2,92S,552 4,107.398 2.312,289 3.441,546 7,032,950 5.753,835 10,210,302 7.132,957 Th& fin8nd81 stalem•nls were approvtrd by tho Truslaes on ... Mr A Lan¢asl¥r TnJ4t•• Mr P Watson TruBt•• Company R•9l•tratlon No. 03140347 '.r•l-. li) pi'!Hl ￿ frl,14P:¢- ¢JlAlt,'.IFV.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 31 DECEM8ER 2021 2021 2020 Noto5 Cash flows from opgr&ting aetlvltl•s Cash generated from operations 28 3,004,484 1,775,872 Invosting a¢tivltl•s Purchase of tangible fixed assets Inv8slment income 152.3101 16,809 142,0271 15,037 N•t co¥h used In Invejtlng actlvltlè# 135,5011 {26,9901 Net cash utsd In flnanclng actlvltl•8 Not Increaso In cash and cash 8qulvalent• 2,968,983 1,748,882 Cash and cash gquivalenls al beginning of year 5,064,475 3,315,593 C8$h and cash •qulval•nt8 at end of year 8,033,458 5,064,475

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 31 DECEMBER 2021 Accounting policies Charity infomiatlon The L&prosy Mission England, Wales, the Channel Islands and the Isle of Man is a private company limited by guarantee incorporated in England and Wales. The registered oNice is The Leprosy Mission, Goldhay Way, Orton Goldhay, Pel8rborou9h, PE2 5GZ, United Kingdom. 1.1 Accountlng convention The charity conslilutes a publlc benefit entity as deflned by FRS 102. The financial slalernenls have been prapared in accordance with Accounting and Reporling by Charities". Slalemenl ol Racommended Practice applicable lo charities preparing their accounts in accordanc8 with the Financial Reporting Standard appli¢able in the UK and Republic of Ireland IFRS 1021 effective 1 January 2019, the Financial Reporting Standard applicable in the United Kingdom and Republic of Ireland IFRS 1021, th¢ Charities Act 2011, Ihg Companies Act 2006 and UK Generally Accepted Practice a5 il applies from l January 2015. The financlal slalemènts are prepared In sterllng. whlch Is the funcllonal currency of the charity. Monetary arnounls in these finanGi81 slalemenls are rounded lo the nearest £. The financial slalemenls are prepared on a going concwn basis under the historical cost convention. moLlified lo include certain il8ms al fair value. 1.2 Going concern The financial slalernenls have been prepared on a going concem basis as the Trustees belleve th81 no material uncerlainlies exist. The Trustees have considered the level ol funds held and the expected level ol income and gxpenditure lor 12 months from aulhorising these financial sialements, including the continued impact of COVID-19. The budgèted income and expenditur8 is sufficient with the level ol reserves for the charity lo be able lo continue as a going concern. 1.3 Income All Incoming resources are included in the Slalemenl of Financial Aclivilies ISOFAI when the charily is legally enlitted lo the income after any performance conditions have been mel, Ihe amount can be measured reliably and11 Is probable that the Income wlll be received. For donations lo be recognised the charity will have been notified of the amounts and Ihe selllemenl dale in writing. 11 there are conditions attached lo the donation and Ihls requires a level of performance before enlillemenl can be obl8ln&d then income is def8fr8d unlll those conditions are fully mgt or the fulfilmenl of those conditions is within the Gonlrol gf the charity and il is probable that they will be luifilled. For legacies. enlillemonl is the eadier of the charity being notified of an impending distribution or the legacy being received. Al this point incorne is r8cognised. On occasion legaci8s will be notified lo the ch8rity. However it is not possible lo measure the amount expected lo be dislribuled. On these occasions, the legacy is treated as a Gonlinggnl asset and disclosed. Th8 charity receives government gr8nls in respect ol ils aclivilie5. Income from govemmenl and other grants ar8 rgcognised at fair value wh8n the charity has anlillemenl after any perforrnance conditions hav8 been mel, it is probable that the income will be received and the amount can be measured ￿lIablY. If entillemenl is not met then Ihese amounts are def8rred. Income from trading activities includes income earned from fundraising events and trading activities lo raise funds for the charity. Income is receivecj in exchange for supplying goods and seNices in order lo raise funds and is recognised when enlitsemenl has occurrg¢J.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS {CONTINUED} FOR THE YEAR ENDED 31 DECEMBER 2021 Accountlng pollcles {Contlnugdl Investment income is earned through holding assets for inveslrllenl purposes such as shares and propety. 11 includes dlvldends, interest and renl. Where il is not practicable to identify investment management costs incurr8d within a scheme with reasonable accuracy th8 Investment income Is reported nel of these c051s. 11 is included when the amount can be measurgd reliably. Inlergst income is recognised using the effective interest method and dividend and rent income is recognised as the charity s right lo receive payrnenl is established. 1.4 Expendlturg AJI expenditure Ss accounted for on an accruals basls and has been classified under headings thal aggregate all costs related lo the c818gory. Expandilure is recognised where there is a legal or constructive obligation lo make payments lo third parties, il is probable that the s8tllemenl will bè requirad and the amount ol th8 obligation can be measured reliably. 11 Is ¢alegorised under the following htsadings.. Costs of raising funds., Expenditure on charitable actsvilies.. and Other expenditure repres8nl8 those ilems not lalllng Into the categories above. Gr8nls payable lo third parties are wllhin the charitable obleclives. Where unconditional grants are offered, thi5 is accrued as soon ès the recipient is notified ol the grant, as this gives rlse lo a reasonable exp8clalion that the recipient will receive the granls. Whore grants are conditional relating lo performance then th8 grant is only accrued when any unfulfilled conditions Are outsid& of tha control ol the charity. Support costs are those Ihal assist the work of Ihg charity bul do not directly represent charitable activllies and include office costs, governance co8ls and other adminislralive cos13. The allocallon of support costs includes an element of judgement and the charity has had lo consider the cost bgnefil Df detailed calculations and record keeping. The allocalions shown are therefore the best estimate of the costs incurred in providing IT, payroll, finance and other central seNic8s for the charlly. Cost allocation has been allrlbuled on the basis of èslimaled time spent on each acllvily or If Ihls 15 not appropriate then on a basis consistent with the u88 01 resources. 1,5 Tanglblo fixed assets Tangible fixed assets other than freehold land are slated al cost less deprecialion. Deprocialion is provided at rates calculated lo write off the cost less eslimaled r8sldu81 valutr of each asset OV81 Ils expected useful life, as follows.. Frèehold buildings Improvements lo property Fixtu￿$, fillings & equipment Motor vehicles 2 per cent of cost per 8nnum 10 per cent and 20 per cènt of cost per annum 33 113 per cent of cost per annum 25 per cent of cost por annum Th8 gain or loss arising on the dispos81 of an asset is determined as the differanc& between the sal8 proceeds and the cafrying value of the asset, and is recognised in nel incomellexpendilurel for the year.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS {CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 Accountlng pollcles {Continu•dl 1.6 Flxed asset Investments Inveslm8nls are recognis8d initially al fair value which is normally the transaction price excluding transaction costs. Subsequently, they are measured al fair value with changes recognised in 'nel gains I 1105sesl on inveslmenls, in th8 SOFA if the shares are publicly traded or their fair value can otherwise b8 measured reliably. Other Investments are measured al cost less impairment. Inve81menl properties lor which fair value c8n be measured reliably without undue cost or effort are measured al fair value al each reportlng dale with changes in fair value recognised In 'nel gains I Ilossesl on inv&slmenls' in the SOFA. 1.7 D•btors and crgditors re¢elvabl•lpayable wlthln one yèar D&blors and cr8dilors with no slated interest fate and receivable or payable wilhln one year are recorded al Iransacllon price. Any losses arislng frm impairment ar8 recognised In exp8ndllure. 1.8 Cash and cash gqulvalgnt$ Cash and cash equiva18nls include cash in hand, deposits held al call with banks, other short-lerm liquid investments with origlnal malurilies ol three months or less, and bank ovèrdrafts. Bank overdrafts are shown within borrowings in current liabilities. 1.9 Flnanclal instruments The charity has elecle¢J lo apply the provisions of Section 11 'Basic Financial Inslrumenls, and Sechon 12 'Olher FlnancSal Instruments Issues, of FRS 102 to all ol Ils flnaneial inslrumenls. Financial instruments are recognised In the charity's balance sheet when the charyly becomès party lo the conlraclual provisions of the inslrumenl. Financial assets and liabilities are offset, with the nel amounts presented in the financial slalemenls, when there is a legally enforceable right lo sel off the recognised amounts and there is an intention lo setlle on a nel basis or lo realise th9 8S5el and sellle the liability simultaneously. Bas1¢ financlal assols Basic financial assets, which include debtors and cash 8nd bank balances, are initially measured al transaction prico including transaction costs and are subsequently carried at amortised cost using the effective interest method unlgss the arrangement conslilules a financing Iransaclion, where the transaction s measured at the present value of the future receipts discounted al 8 m8rk8t rale of interesl. Financi81 assets classified as receivable within one year are not amortised. Basic financial liabilities Basic financial Iiabililies, including creditors and bank loans are initially recognised al Ir8nsaclion price unles5 the arrangement conslilules a financing Iransactlon, where the debt instrument is measured al ihe present value of Ihg future paymen15 di5counled al a market rale of int8resl. Financial liabilities classili8d as payable within one year are not amortised. D8bl instruments are subsequenuy carried al amortised cost, using Iha eftgcIIv9 interest rate method. Trade creditors are obligations lo pay for goods or services that have been acquired in the ordlnary c(MJrse of operations from suppliers. Amounts payable are classified a8 current liabilities il payment is due wilhin one year or less. If not, they are presented as non-current liabilities. Trade creditors are recognised ini118lly al transaction price and subsequently measured at amortised cost using the effective interest method.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED FOR THE YEAR ENDED 31 DECEMBER 2021 Accountlng pollcles Icontlnued) 1.10 Employee benefils When employees have rendered service lo th8 charily, short-lerm employee b8nefils lo which tha employees are entitled are recognised at the undiscotjnled amount expected lo be paid in exchange for Ih8t seryice. The Company particlpales in a non-conlributory mulli-employer pension scheme, that has been closed lo new members, providing benefits based Ljpon c3refrr averaged revalued earnings. The company s pension conlrlbullons are determinèd by 8 qualifled actuary on the ba8Ss of Iriennlal valuations. The actuary has identified the proportion of the group scheme liabilily which is owed by The Leprosy Mission England, Wales, the Channel Islands and the Islè of Man. A provision has been included in the accounts and the conlribulions lo reduce the deficit are accounted lor when pald. For defined conlribulion schemes the amount charged lo the Statement of Financial Activities in respect of P8nsion costs and other posl-reliremenl benefits is the contributions payable in the yèar. Differences belween contributions payable in the year and contributions actually paid are shown as either accruals or prepayments in Ihg balance sheet. 1.11 Loa¥e¥ Rentals payabl8 und8r operating leases 818 charged against income on a slraighl line basis over the period of the lease. 1.12 Forèlgn exchangè Transactions denomlnaled in foreign currencies are racordeé al the ral8 ruling al the dale of the Iransaclion. Monetary assets and liabilllies denomlnaled in foreign currencies are translated inlo slerfing al the rales of exchange ruling al th8 balanc8 she91 dalg. All diff8rgnces are included in n81 outgoing resources. 1.13 Fund accountlng Funds held by the charity are either.. il Unrèslricl8d g8neral funds these are funds which Gan b8 uséd in accordance with the charitable objects al the discretion of the Trustees. 111 Deslgnated funds these are funds sel aside by the Trustees out of unrestricted geneml funds for SP8ciflc purposes or prolecls. iiil Reslricled funds these are funds Ih81 can only be used for particular restricted purposes within the objects of the charity. Crltlcal accountlng e8tlmatès and Judgèment8 In the application of the charity's aCcoun￿'ng policies, the Trustees are required lo make judgements, eslimal8s and assumption5 about Ihg carrying amDunl ol assets and Iiabililies that are not readily apparent from other sourGeS. The eslimales and assoGialed assumption5 are based on historical experience and other factors that are considered lo be relevant. Actual rasulls may differ from these eslimales. The estimates and undedying assumptions are ieviewed on an Dngoing basis. Revisions lo accounting estimates are recognised in the period in which the estimate is revised where the revision affects only that period, or in the period of the revision and lulure periods where the levision affects both current and future periods.

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 Donatlons and legacles Unrestricted Restricted funds lunds Total 2021 Total 2020 Individual supporters Donations through Isle of Man TLM Trading income Legacies rece+vable Government and inslilulions Community lundraising Trusts and foundations Gift Aid Stamps and collecl8ble3 Other donations 2.430.016 1,695,466 4.125,482 2.921.032 48,318 48,318 31,668 189,817 268.441 458,258 464,106 4,056,339 132,099 4,188,438 3,876,726 1,383,011 1.383.011 1,279,357 284,212 679,071 586,160 309,391 451,901 203,006 541,105 435,907 42.701 34.378 25,616 25,353 394,859 142,510 541.105 42,701 25,616 For the yoar ondod 31 Docomber 2021 7,871,281 4,072,620 11,943,901 9,857,693 For the year ended 31 December 2020 6,924,555 2,933,138 9,857,693 Grants rec•lvabl• for corè actlvltlgs InGludod In the abov• Jersey Overseas Ald Guernsey Overseas Aid & Developmenl Commisslon Isle Of Man Governm8nl FCOOAid Match Heal Nepal FCDO Rapid Respons& C.19 Tearfund FCDO FOUND Comic Rellef Irish aid RIGHT1 Advocacy of Empowerment 29.731 46,665 29,731 4e,665 224,716 44,932 49,500 702.752 372,813 84.109 115,129 69.28S 50,000 247,914 293,698 172.014 101,205 770 26,372 3,399 702,752 84,109 69,285 247,914 172,014 770 26,372 3,399 21,464 5,900 Grants from Governm•nts and Instltutlonj 1,383,011 1,383,011 1.279,357 H8verslock Ch8rilable Trust The Kirby Laing Foundation Sl Lazarus Charitable Foundation The Bridgewaler Charitable Trust The James Tudor Foundation 14,642 236,802 29,432 14,642 236,802 29,432 2.500 30,402 56,000 17,689 Othgr grants 280.876 280,876 106,591 1,663,887 1,663,887 1,385,948 Co-lunding for FCDO funded projects was provided from other donofs. Th8 Corrèsponding expenditure is included within grants payable (see note 8).

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS {CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 Income from investments 2021 2020 Rental Income Income from listed investments Interest receivable 10,395 83 6,331 10.418 101 4.518 16,809 15,037 Income from investments is atlribulable lo unreslricled funds. Other Income Unr6strlct•d Unreslriclèd funds funds 2021 2020 Job retention scheme income 6,585 116.704 Expondltur• on ral•lng fund• 2021 2020 Fundraising appeals Marketing and communications Community lundraislng and volunteering Staff costs 952.977 106.972 32.636 1,246,893 695.829 146.313 55.968 1,124,671 Costs of gener81ing voluntsry income 2,339,478 2,022,781 ve 1,155 1,355 2,340,633 2,024,136

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS {CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 Expend•tur• on charltable activities 2021 2020 Staff Costs Advocacy JOA- CLRS Ethiopia - UK costs RIGHT 1- UK costs FCDO FOUND- UK costs Mozambique LCP - UK costs Projects- UK costs 242.301 4,055 207,339 5,012 24,931 1,645 6,010 15,453 18.469 264,825 260.390 Grant funding of acllvilies Ise8 note 81 5,417,810 4.383,055 Share ol support costs Isee nole 9} Share ol governancè cosls18ee note 91 987,838 63.688 934.813 78,236 6,734,161 5,656,494 Analy$ls by fund Unreslriclod funds Reslricled funds 4,459,771 2,274,390 3,049,398 2,607.096 6.734,161 5,656,494 Grjnts payable 2021 202Q Grants lo inslilulions.. The Leprosy Mission Inlern81ional, Brenlford, UK Stepping Stones Brighter Future India TLM Mozambique TLM Nepal ENAPAL TLM Nigeria TLM Elhiopia 3,781.353 24,553 89.574 203,599 1.112,531 3,251,422 19,197 74,462 103,838 722,205 46,854 165,077 103,194 103,006 5.417,810 4,383,055

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 Support costs Support Govemance costs costs 2021 2020 Staff costs Depreciation and loss on dlsposal ol fixed assets Management, finance and adminislralion 533,775 95,719 358.344 26.140 559,915 95,719 358,344 554,737 90,136 317,667 Audit lees Legal and professional 8oard and committee 8xpens&s 8,160 29,388 8,160 29,388 7.800 42,204 505 987,838 63,688 1,051,526 1,013,049 10 Th18tees' and koy managgmont personnol r•munorotlon and •xpenso8 None of the Trustees lor any persons connected with them) received or walved any remurberalion during the year. Thè Chlef Executive Officer of The Leprosy Mission England, Wales, the Ch8nnel1sland$ and the Isle of Man is the company secretary and a non-voling ex-offlcio member ol the Board of Trustees. Thè lolal amount of employee benefits received by key management personn81 is £88,534 12020 - £78.8051. The charity considers ils key managtsmenl personnel comprises of the Chief Executive Officer. Durlng the year no Tiust88s were reSmbursed any expgnses12020 - one Trustee was relmbursèil £2661.

THE LEPROSY MISSION ENGLAND. WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 11 Employee$ Number of8mployees The aver8ge monthly number of employees and full lime equivalent IFTEI durlng the year was: 2021 Number 2021 FTE 2020 Numb•r 2020 FTE Management and administration Fundraising and publicity Project support and development 12 21 14 13 21 13 12 20 20 13 47 44 47 45 Employm•nt costs 2021 2020 Wages and salaries Soclal $6curily costs Olhgr pension costs 1,615.778 163.023 160,785 1.500,861 152,712 166.255 1.939,586 109,523 1,819,828 66.919 Other staffing costs 2,049,109 1.886,747 Included In the abové ara rèdundancy costs of £15.776 which relate lo two employee$12020- £31,039 relallng lo three employees). Staff costs include nine12020- sevenl posts that are full or partly funded by Inslilutlonal donors, lolalling £176,724 {2020 . £157,475). The number of ernployees whose annual remuneration was £60,000 or more were: 2021 Number 2020 Number £70,001- £80,000 £80.001- £90,000 Pension contributions of £7,82512020 £7.5431 wère made lo Friends Life on behalf ol one higher paid employee.

THE LEPROSY MISSION ENGLAND. WALES. THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 12 Net galnsl{losse$l on Investrnents Unrestrlcted Unreslricled fund5 funds 2021 2020 Revaluation ol investments Revaluation of investment properties 11 S61 185.000 72 184,844 72 13 Taxatlon The company is a regisler8d charlly and as such, for tsxalion purposes, is enlilled lo exemption from United Kingdom lax81ion under section 505 of the Income and Corporation Taxes A¢1 1988 or 59clSon 252 of the Taxation of Charggable Gains Act 1992. 14 T•nglblg flx9d assets Land and Improv• Flxturo$, bulldlngs ments to flttlngs & proporty oqulpmont Motor vehlclo• Total Cost Ai 1 January 2021 Additions Dl8posals 427,519 197,956 432.017 26,611 25,699 1162,3721 1157,4551 29,013 1,086,505 52,310 1319,8271 Al 31 December 2021 427,519 62,195 300,261 29.013 818,988 Dopreclatlon and Impalrmont Al 1 January 2021 Deprocialion charged in the year Ellminaled In respect of disposals 137,908 5,700 192,510 270,895 4,471 85,548 1162,3721 1157,4551 29,013 630,326 95,719 1319,8271 Al 31 December 2021 143,608 34,609 198,988 29,013 406,218 Carrying amount At 31 December 2021 283,911 27,586 101,273 412.770 Al 31 December 2020 289,611 5.446 161,122 456,179

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED FOR THE YEAR ENDED 31 DECEMBER 2021 15 Fixed ass&t Investments Listed Investment Invg$tmonts propertl88 Total Cost or valuatlon Al 1 January 2021 Valuation Changes 3,366 11561 482,481 185,000 485,847 184,844 At 31 December2021 3,210 667.481 670,691 Carrylng amount Al 31 December 2021 3,210 867,481 870,691 At 31 Decembei 2020 3.366 482,481 485,847 The fair value ol the investment propeity ha8 bean arrived al by a formal valuatlon on an op8n market value basis. The fair value of listed inveslm&nls is dglerniined by reference to the quoted prlce for Identical ass81s in an active market al th8 balance sheet date. 16 Flnanclal Instrum•nt8 2021 2020 Carrylng gmount of Ilnonclal assets Listed investments Legacles recelvable Income lax recovgrable Othèr debtors Bank and cash 3,210 978,000 64,314 309,347 8,033,458 3,366 924.299 39,088 377,561 5,064,475 Measured at cost 9,388.329 6.408,789 Carrylng amount of flnanclal118bllltlg$ Other laxalion and social security Trade creditors 47,915 81,013 38,353 77,489 Measured at cost 128,928 115,842

THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED) FOR THE YEAR ENDED 31 DECEMBER 2021 17 Dèbtors 2021 2020 Amounts falllng due wlthln one year: Legacles recoveiable Income lax recoverable Other debtors Prepayments and accrued Incom8 978.000 64.314 309.347 55,124 924.299 39.088 377.561 64,614 1.406,785 1,405,562 18 Credltor8: amounts falllng dua within ong y8ar 2021 2020 Other laxalion and soc181 securfly Trade creditors Other creditors Accruals 47,915 81,013 14,348 170.126 38,353 77,489 28,427 134,837 313.402 279,106 19 Pon¥lon and other po8t.rntlr•m•nt b•neflt commltment$ The Cornpany participates in 8 non-conlribulory rnulli-employer pension scheme providing benefits based upon career averaged revalued earnings. The company's pension contributions are determined by 8 qU81ified actuary on the basis ol triennial valuations. The company's share of the underfylng assets and Ilabililies of the scheme is eslimalod lo be £nil12020 - £nill. After laking into account the results of the trlennial valuation carrigd out as al 31 December 2018, it ha8 been agreed to continue lo make contributions of £90,000 per annum of which The Leprosy Mission England, Vvales. the Channel Islands and the Isle of Man woll conlrlbule £22.000 per 8nnum. Thes8 payments will increas8 each year in line with the Retail Prlces Index. The contributions will bo reviewed al the next Iriennlal valuation. Thè career averaged revalued earnings scheme has been closed to new members effective from 12 November 2007 and has been closed to future accrual from 1 Aprll 2013. A Group Personal Pension Scheme IGPPI has been sel up with Aviva. Employers make contribution of 10°A of the monthly pensionable salary lo Aviva. The company's total pension cost for the year amounted lo £160,785 {2020 - £166,255).

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THE LEPROSY MISSION ENGLAND, WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS (CONTINUED FOR THE YEAR ENDED 31 DECEMBER 2021 23 Operatlng lease commitmonts Al the reporting end datg the charity had oulslanding commitments lor fulura minimum lease payments undgr non-cancellable operating leases, which fall du8 as follows.. 2021 2020 Within ona year Between two and fivè years 1.879 3,83S 1,970 1,854 5,714 3,824 24 Continggnt as8ot$ The charity has been nolifled of legacies with an estimated value of £1,496,000 which have not been recognised as income 8131 December 2021 because no notifl￿tiOn of impending distribution or approval of eslal8 account8 has been rèceived. 25 Rolatad paity transactlon$ Thère wère no disclosable related paty Iransacllons during th8 ygar12020- none). 26 Subjldlarles On 3 July 2018, The Leprosy Mlssion l$10 of IAan was Incr)rporaled as a comp8ny Ilmlted by guarantee, under th8 Companies Acts 193110 2004 by the Department for Enlerpriso Isle of M8n. Since formation the charitable company has been a subsidiary of The Leprcssy Mi9810n England, Wales, the Channel Islands and the Isle ol Man. The charitable company has been collecting donations during the course of the year. lolalling £48,318 12020 - £31,668). which have all been pald to The Leprosy Mission En9land, Wales, the Chann81 Islands and the Isle of M8n. 27 Analy818 of changes In n•t funds At 1 J•huary 2021 •sh Iltsws At 31 Do¢emb8r 2021 Cash al bank and in hand 5.064,475 2,968,983 8,033,458 5,064.475 2,968.983 8,033,458

THE LEPROSY MISSION ENGLAND. WALES, THE CHANNEL ISLANDS AND THE ISLE OF MAN NOTES TO THE FINANCIAL STATEMENTS ICONTINUED) FQR THE YEAR ENDED 310ECEMBER 2021 28 Cash gonorated from operations 2021 2020 Surplus for the year 3,077,345 2.308,876 Adjuslmenls for.. Investment income rocognised in slalemenl ol financial aGlivilies Fair value gains and losses on inve8lmenl properties Fair value gains 8nd losses on investments Depreciation and imp8iimenl of langible fixed assets 116,8091 1185,0001 115,0371 1721 90,136 95,719 Movements in working capital: Ilncreasel in debtors Increase In creditors 11,2231 34,296 1612.6311 4,600 Calh g•nèr#tgd from oporatlon• 3,004,484 1.775,872

TANIA (FRONT COVERI 27 15 THE MOTHER OF TWO CHILDREN HIR TWO-YEAR-OLD 50N IS PICTUftED WITH HER "WHAT IF OiJR CHILDREN SUFFIR FROM TH15 DISEASI) IT S MY BIGGEST NIGHTMARE. I JUST CANNOT IMAGINE IT SO. I HOPE AND PRAY ftESEARCH WILL BE DONS. AND TRÉATMENT WILL BE THERE SO THAT THEAE WILL BE NO LONGER BE ANY UNTREATED CASES OF LEPROSY IN OUR COUNTR Y OR TF+E REST OF THE WORLD" -BECALISE OF THI DOCTORS AND NURSES WF ARF ABLE TO RETURN HOME TO OUR FAMII Y HAPPY I WANT TO I IVF FOR MY CHILDREN AND I AM NOT GOING TO GIVE UP ON LIVING- Pho(ograDhrf i¢J Fab$ha Monir The Leprosy té The Leprosy Mission England. Wale$. the Channel Islands and the151e of Man, Mission Goldhay Way. Orlon Goldhay Peterborough. PE2 5GZ Ertg￿nd and Wale5 01733 370505 [e-mail] leprosymisslon.org.uk The Leprosy Mlssion England & Wale5 @ProgrammesTLMEW @leprosytalk leprosymission FUNDRA151NG REGULATOR Registwed Cl)arity No 1050327 A Company limited by Guarantee Registered in Englènd and W81es No. 5140347