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Status of Leprosy in the Region of the Americas

Table with country data | Prevalence Map  | PDF Version (3 pp, 211 Kb)

Description of the Current Situation

The WHO Region of the Americas consists of 35 countries with a total population of approximately 879,617,000 inhabitants as of 2004. In the Region, there are very large countries—such as the United States, Brazil, and Mexico—that represent 66.2% of the total population, as well as very small countries—such as Grenada, Aruba, Dominica, Antigua and Barbuda, and Bermuda, among others—that make up barely 0.06%.

In the 1980s, the development of Multi-Drug Therapy (MDT) for the treatment of leprosy constituted an important milestone for controlling the disease. The use of MDT in control programs started between 1982 and 1985 and by the 1990s was being used at global level. The reduction in prevalence observed from MDT use during the first few years inspired the 44^th World Health Assembly, held in 1991, to adopt a resolution to eliminate leprosy as public-health problem by the year 2000. This would entail a case prevalence of less than one reported case per every 10,000 inhabitants.

Even though the goal of elimination was reached at global level by end of 2000, some individual countries did not manage to reach it. For this reason, in 1999 the deadline for meeting the goal was extended to 2005.

In the Region of the Americas, MDT implementation began in 1985. Its coverage in 1990 reached 42%; and by 2001, coverage was almost universally available. This result was achieved by the implementation of national elimination plans based on stratifying the problem in accordance with the Regional Action Plan for Leprosy Elimination in the Americas promoted by PAHO in 1992. Its impact on reducing the disease burden could be observed over the period between 1992 and 1999. Leprosy prevalence dropped by 80%, resulting in a reduction in incidence from 8.1 per 10,000 inhabitants in 1992 to 1.4 in 1999.

During the Third Regional Conference on Leprosy Elimination held in Venezuela in 1999, PAHO proposed a Regional Consolidation Plan for Leprosy Elimination involving a strategy for monitoring the epidemiological situation of the countries at national and subnational levels.

To date, the regional prevalence rate indicates that leprosy has been eliminated at regional level. As a result, continued efforts should be made to consolidate elimination and arrive at the interruption of the disease, since it contributes to the perpetuation of poverty in areas where the population of persons with disabilities continues to be an economic and social burden.

Table 1 below summarizes the latest data sent to PAHO by the countries of the Americas at the beginning of 2005. Out of a total of 35 countries, 23 have sent information on their program:

Table 1: Status of Leprosy in the Region of the Americas (beginning of 2005)

According to the data reported in the table, it can be observed that only Brazil, Guyana, St. Lucia, Suriname and Paraguay have not achieved the goal of elimination.

The government of Brazil predicts that, by the end of 2005, the country will have achieved its goal at national level; and by 2010, subnational level. Integrated strategies are being implemented to this end.

Leprosy Prevalence 2004 (Region of the Americas, rates per 10,000 inhabitants) Note: The data from El Salvador, Guatemala, Haiti, Nicaragua, Peru and Uruguay are from 2002.

For the remaining four countries that still have not reached the goal, there are plans to increase program coverage by integrating activities to fight leprosy at the level of primary-care services. In order to continue with progress made to date, there are plans to hold a regional meeting involving the participation of national program managers from the countries. The main objective of this meeting will be to "Socialize the Global Strategy for Further Reducing the Leprosy Burden and Sustaining Leprosy Control Activities." PAHO Leprosy Page