Leprosy in the world today

Abstract

The constraints for leprosy control result mainly at present from inadequate infrastructure, from inadequate methodologies for case detection, and the severe shortcomings of dapsone monotherapy. Possibilities for improving treatment methods already exist by means of combined chemotherapy, but there has been difficulty in putting them into practice. It might be possible, however, to solve these difficulties by intermittent administration of drugs. At the same time, by increasing the number of drugs in the regimens, their efficacy could be increased. On the whole, based on presently available concepts, the development of an effective antileprosy vaccine remains an essential requirement for an effective strategy for leprosy control. As for what WHO intends to do, in close collaboration with its Member States during the next decade, this can be summarized as follows. improved technologies for case detection, especially early detection, treatment with chemotherapy, case holding and contact follow-up will be promoted through the development of more effective control planning, programme management and training. Field application will be encouraged of significantly more effective control methods expected from the increased efforts in leprosy research. Curricula incorporating proven approaches will be constructed for the training of all levels of health workers - from the medical undergraduates to the primary health care personnel. The participation of national experts will be promoted in management and evaluation. Collaboration with international bilateral and voluntary agencies will be encouraged. According to the progress made, operational studies on vaccination will be initiated.