Worldwide elimination of leprosy: historical journey from the past to the future

Abstract

Leprosy was considered incurable until the 1940s, when sulfones were discovered and gave hope for eradicating the disease. The emergence of dapsone-resistant bacteria, during the late 1970s, resulted in developing a multidrug therapy using rifampicin, curing more than 12 million patients worldwide. Most countries succeeded in achieving the target set by WHO to reduce prevalence to less than 1 per 10,000 population (elimination of leprosy) by the year 2000, and all countires succeeded by 2005. However, incidence rates have continued to remain high in several countries. Despite free multidrug therapy available through integrated health centers, owing to stigma and other factors, many patients, especially of multibacillary type, delay treatment, resulting in irreversible disabilities in the patient, and continued transmission of infection. Inadequate surveillance, poor research, dissemination of accurate information and declining political support add to the problem of not developing more effective strategie...