Elimination of Leprosy in 21st Century: Opportunity and Challenge

Along with the implementation of LEC and SAPEL and introduction and multidrug therapy (MDT), leprosy epidemic has been markedly controlled worldwide, the number of countries with prevalence of more than 1 per 10000 population decreasing from 155 in 1985 to 32 in 1997. In the past decade, many international government organizations and non-government organizations (NGOs) expressed a great enthusiasm to elimination leprosy as public health problem. At moment, regarding the elimination of leprosy, there are a lot of opportunities but also challenges: (1) significant decreasing of prevalence at global level, but more than 90% of leprosy patients are still focusing on 16 top epidemic countries; (2) there are a big gap between registered number and actual number of cases, many patients being still not detected and treated; (3) although prevalence rate could significantly decrease partly because of some operational factors, the incidence or detection rate still remains at a high level for a long time; (4) in many countries, poor economy makes leprosy control more difficult; (5) in some epidemic countries where leprosy has been successfully controlled, sustainability of leprosy control is a big challenge; (6) many NGOs who gave a lot of support to leprosy control before has changed their new investment to AIDS or other infectious diseases; (7) not only physical but also social and economic rehabilitation will be big task and challenge in leprosy control in 21st Century.