Leprosy is one of the oldest scourges of humankind. Accurate portrayals of the disease in Chinese medical treatises date from 400 bc, and classic descriptions in ancient Indian literature occur even earlier.1 In our western tradition the fear and loathing directed towards the disease come directly from the bible. Leprosy was the “disease of the soul”, the “punishment for sin”. By the dawn of the Middle Ages the leper had become the universal symbol of persecution, the diseased and disenfranchised outcast of Western society.2 Even though the prevalence of leprosy steadily declined in Western Europe after a peak in the 14th century, it became epidemic in other parts of the world, especially in Asia, Africa, and South America. Until the introduction of dapsone in the 1940s there was no effective treatment for leprosy, and infected individuals were routinely isolated and segregated from all contact with society. In some areas of the world this approach continued until well into the 1980s, even after a number of highly effective antileprosy drugs had been developed.

Today the prevalence of this ancient disease is …