Leprosy in Africa today.

LEPROSY constitutes one of the biggest and most complex of the many problems confronting the medical services in Africa today (Leonard Wood Memorial, Washington, I96I; WHO, I960) and, despite the efforts of governments and ancillary agencies and the success of sulphone therapy, leprosy will continue to be a problem-medical, administrative, economic and social-for many years to come. It is not that leprosy is a killing disease like tuberculosis or trypanosomiasis, or that it can rapidly assume epidemic proportions like yellow fever or smallpox. It is a chronic infectious granuloma affecting mainly the peripheral nerves and the skin; but this bald statement fails to indicate both the far-reaching consequences of anaWsthesia and paralysis of the extremities and deeply ingrained prejudices that have for centuries regarded leprosy as a disease apart and its victims as beyond the pale. In Africa these prejudices may produce an inertia and a callousness and a fear difficult to understand and to overcome. While there may be reasons historical, emotional and social-for considering leprosy as a special problem calling for special measures, the tendency now (fortunately and belatedly) is to regard leprosy as part of the public health problem of transmissible disease in an environment characterized by lack of hygiene and undernutrition. It is arguable that the progressive raising of standards of hygiene may play as great a role in the control and eventual eradication of leprosy in Africa as it did in medieval Europe, with the proviso that local circumstances may render the task even more difficult and more' protracted than present-day experience is discovering in the American States of Florida, Louisiana and Texas. Fortunately, the use of a proved drug and the application of known principles do not have to await the elucidation of all that is obscure and unknown.