We rarely think about this scourge in the U.S.A. The latest review by the WHO shows remarkable progress.
Europe was so badly affected during the 13th century that by 1225 there were around 19 000 leprosaria—hospitals to house lepers. By 1350, the disease started to wane in Europe, possibly because the black death killed so many of Mycobacterium leprae's hosts. But today M leprae's effects are still seen worldwide, especially in India where 260 000 of the 408 000 people diagnosed in 2004 reside.
In 1991, the World Health Assembly adopted a resolution to eliminate leprosy by 2000, defining elimination as reducing the prevalence to below one case per 10 000 population. By 2005, the goal had not been met, despite the provision of free multidrug therapy by Novartis from 2000 onwards. Despite these failures, there will be a great deal to cheer about on World Leprosy Day on Jan 29. In 1985, 122 countries had prevalence rates above one case per 10 000. Now, only nine do: Angola, Brazil, Central African Republic, Democratic Republic of Congo, India, Madagascar, Mozambique, Nepal, and Tanzania.
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