ELIMINATION OF LEPROSY AS A PUBLIC-HEALTH PROBLEM - PROGRESS AND PROSPECTS

Leprosy is still an important problem in about 80 countries of Asia, A frica and Latin America, some 2.4 million persons being estimated to h ave the disease in 1994. The WHO-recommended standard multidrug therap y (MDT) was introduced in the 1980s and has been shown to be effective in combating the disease. Experiences based on many thousands of pati ents treated with MDT over the past decade indicate extremely low rela pse rates (cumulative relapse rates around 1%). By the end of 1993, so me 5.6 million patients had been cured, and the global cumulative MDT coverage of registered patients had reached 89%. The number of registe red cases fell from 5.4 million in 1985 to 1.7 million in 1994. The si gnificant progress made in leprosy control enabled the World Health As sembly in 1991 to set a goal for eliminating leprosy as a public healt h problem by the year 2000. One important epidemiological factor is th at leprosy is very unevenly distributed: 80% of the problem is confine d to only five countries and 92% to just 25 countries. The elimination strategy envisages identifying and treating with MDT a total of about 5 million cases from 1994 to the year 2000. The cost of dealing with these cases has been estimated at US$ 420 million, including US$ 150 m illion for the drugs.