At the beginning of the 1990s, the WHO proposed their ‘‘final push strategy’’ for leprosy with

the clear purpose of elimination, defined as a prevalence below a single case per 10 000
inhabitants in endemic regions.Countries like the Democratic Republic of the Congo and
Mozambique reported reaching the goal, but the disease remains highly prevalent in other parts
of the world. Lower prevalence rates are unrelated to the reduction in the number of new cases
found. This change in prevalence does not reflect a decrease in M leprae transmission; rather, it
is related to the shorter period of treatment recommended by the WHO or to the exclusion from
registries of patients who have been cured or who have died. Countries where leprosy had
previously been eliminated report a rise in imported cases; one example is Spain, where most
imported cases have come from South America or sub-Saharan Africa.