The leprosy endgame in Malawi: From leprosy control project to national public health resource

Leprosy is in decline in most endemic countries around the world. A Lepra-supported project in Malawi has evolved over the last 50 years from a unit initially dedicated solely to the study of leprosy epidemiology and control, to one that can apply its expertise and experience in an ever-widening array of public health challenges. The ultimate result of this process, the reduction of leprosy to very low levels in Karonga (averaging only 1 case per year for the last decade, most of them from outside the district) and the evolution of a leprosy project into a major national resource for medical and public health research in Malawi, may serve as a model for how the leprosy endgame can be managed.