by Cairns S Smith, Ann Aerts, Paul Saunderson et al.
The Lancet Infect Dis 2017 – Published Online July 7, 2017
Leprosy is present in more than 100 countries, where it remains a major cause of peripheral neuropathy and disability. Attempts to eliminate the disease have faced various obstacles, including characteristics of the causative bacillus Mycobacterium leprae: the long incubation period, limited knowledge about its mode of transmission, and its poor growth on culture media. Fortunately, the leprosy bacillus is sensitive to several antibiotics. In 1981, WHO recommended use of three drugs to treat leprosy: rifampicin, clofazimine, and dapsone. Uptake of this multidrug therapy was slow and did not reach 100% coverage until 1997. Global drug donation to provide free multidrug therapy at the point of care was vital to achieving 100% coverage. Use of the shorter multidrug-therapy regimen reduced the prevalence of leprosy by 90% but did not halt transmission. A global leprosy coalition is needed to achieve zero transmission.