In 1991, the World Health Organization (WHO) and its member states committed themselves to the challenge of eliminating leprosy as a public health problem by the year 2000 (1). Elimination was defined as a prevalence of less than one case per 10 000 persons. The introduction of multidrug therapy for leprosy recommended by WHO had a major impact on the global picture of leprosy in the early 1990s (2) and, at the end of the year 2000, the overall prevalence rate at the global level was below one case per 10 000 (3). Of the 122 countries where the disease was considered endemic in 1985, 107 countries have reached the elimination goal. In early 2002, 90% of cases detected worldwide were in the top six countries where the disease is most prevalent and endemic. These comprise India, Brazil, Nepal, Mozambique, Angola and Myanmar. Of these, 70% of the world’s leprosy patients were in India (4). Although no Caribbean country has been named among those countries of concern, the challenge must be elimination in those countries with highest prevalence in order to attain global leprosy control.