In the 1980s, the prevalence of leprosy worldwide was about 12 million cases. In the early 2000s, it was approximately 800 000 cases.1 This dramatic change has been attributed to multidrug therapy (MDT). Two drugs, rifampin and clofazamine, were added to the treatment regimen because Mycobacterium leprae was becoming resistant, and the World Health Organization thought that resistance could possibly be overcome by adding other antibiotics to dapsone. The disease progression was so dire that this addition was done without any clinical trials, which would have taken years to complete. The results have been truly dramatic and perhaps represent one of the most significant advances in medical history that has been largely unheralded.
Allen HB, Moschella SL. The Role of Rifampin in Leprosy Leprosy Through a New Lens. JAMA Dermatol. Published online February 08, 2017. doi:10.1001/jamadermatol.2016.5506