Interpreting data in policy & control: The case of leprosy

Leprosy is an ancient disease, and the WHO target of elimination by the year 2000 in 1991 was perhaps ambitious [1]. This ambition was mitigated by a redefinition of elimination to 'elimination as a public health problem', which means, in reality, the reduction of disease to very low levels. The formal definition of control (reduction of disease incidence, prevalence, morbidity or mortality to a locally acceptable level as a result of deliberate efforts, and continued intervention measures are required to maintain the reduction [2]) recognizes that intervention programmes must be kept going [2],[3],[4]. The redefinition of 'control' to 'elimination as a public health problem' was presumably to develop a political impetus to a defined endpoint; and political impetus is essential for any concerted public health action.