No abstract
SummaryThe contribution of leprosy research to the progress being made toward elimination of leprosy has been critical. A major development in the promotion of leprosy research during the last 25 years has been the initiative taken by the WHO Special Programme for Research and Training in Tropical Diseases (TDR) through two of its scientific working groups, one on the immunology of leprosy (IMMLEP) and the other on the chemotherapy of leprosy (THELEP), which were set up in 1974 and 1976, respectively. IMMLEP and THELEP have greatly facilitated inputs from scientists not usually active in leprosy research. The coordinated efforts of IMMLEP and THELEP also facilitated goal-oriented research toward high-priority target areas such as an anti-leprosy vaccine and newer and better drug-combinations for the treatment of leprosy. Whereas the prospects for a leprosy vaccine appeared very promising in the early years, the first vaccine produced did not meet expectations for several reasons. Moreover, the possibility of using a vaccine in leprosy is not bright, because of both the technical problems as well as the reduced relevance of a vaccine at a time when leprosy is becoming less and less common. On the other hand, the modest expectations for newer and better drug combinations led to multi-drug therapy (MDT) for the control of leprosy. It is the introduction of MDT that is credited with the current global reduction of leprosy and the progress thus far made toward eliminating the disease as a public health problem. Nevertheless, many areas in leprosy, such as nerve damage, remain that require major research inputs in the future.In recent years, tremendous progress has been made toward eliminating leprosy, progress that would not have been possible without the contribution of leprosy research. Until about 25 years ago, the global leprosy situation was rather dismal, and the situation of leprosy research was not very different. In those days, leprosy research tended to remain isolated, with very little input from exciting scientific developments in other areas. Also, leprosy research tended to be confined to clinical issues. Against this background, a major development took place in the mid-1970s, when the World Health Organization, together with the United Nations Development Program and the Wodd Bank, set up the Special Programme for Research and Training in Tropical Diseases, known as TOR, with the aim of promoting goal-oriented, coordinated research in major tropical diseases including leprosy. The impetus to include leprosy came not only because leprosy was a major tropical disease affecting large populations, but also because of major developments in areas of basic research, particularly in immunology. The establishment of TDR followed closely on the discovery that the nine banded armadillo was susceptible to infection by Mycobacterium leprae, and presented the possibility of producing large quantities of the organism for experimental work. The TDR programm e set up scientific working groups in leprosy, one on the im...
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