Abstract
Leprosy is still a significant health problem in many countries. In 2017, 79 nations reported 100 or more new cases of leprosy.1 Between 1985 and 2017, a sharp decline was observed in the reported prevalence of leprosy from 5·2 to 0·21 million.1 Multidrug therapy (MDT) has contributed substantially to this decline, with over 15 million people cured from leprosy since its introduction in 1982. MDT is provided free of cost worldwide by Novartis, and the distribution is managed by WHO. However, global new case detection has remained more or less stagnant in the last 10 years. The substantial proportion of child cases among new cases indicates that the transmission of M. leprae is still ongoing in many countries and areas. A major reason is that M. leprae is a slow growing bacterium and leprosy has an average incubation period of about 5 years.2,3 Persons incubating the disease are infectious at some point during that period, which is likely a major reason why treatment of symptomatic cases has had so little impact on the incidence of leprosy. A second reason is that the activities recommended by the WHO’s Global Leprosy Strategy, such as early detection, contact examination and prompt treatment, were often implemented inadequately. [...]
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