2. What issues are important in defining new policies for leprosy control?
Of course all countries need country-specific policies. I would like to highlight in this presentation some general issues, I think are important in general： some things will have to remain, some things should change.
2.1 Factors that should continue to play a role
2.1.1 The need to maintain political commitment
The first and foremost condition, in my view, to maintain an effective leprosy control programme is political commitment by the decision-makers within the government.
2.1.2 The need to maintain a central unit
In second place, there is certainly a need to maintain a central unit on national or state level, dedicated to Leprosy Control.
This central unit could have the following mainly normative functions：
･ policy formulation.
･ technical guidance
･ assistance in technical training, in programme planning, monitoring & evaluation
2.1.3 The need to maintain international co-operation
A Ministry of Health would probably feel the need to maintain international technical exchange of ideas and experiences, and sometimes advise by experts (WHO, ILEP Medico-Social Commission, ILA) . These contacts are of great importance to maintain a sense of cohesion and to get the necessary innovative ideas.
2.1.4 The need to maintain donor support
Most countries feel the need to maintain internal and external donor contacts and support. At least this should be so during the process of change towards a newly defined policy. This support should ideally prepare towards sustainability, although I accept that this is often a medium-term goal rather than an objective that is feasible in the immediate future.
2.2 What elements should probably be modified?
2.2.1 A change towards sustainability
In situations of low prevalence, the need to strive for sustainable leprosy services is clear： The urgency for a more efficient use of financial and human resources is great. Governments and donor agencies will not be able to maintain large budget votes for a problem that has diminished considerably.
I said diminishing, not disappearing, because it is also clear that residual problems will continue to require attention, both for diagnosis and treatment of new patients as well as for the care and rehabilitation of persons affected by leprosy after their microbiological cure.
2.2.2 Towards self-sufficiency of human resources
I also recognize the need for a country to be able to generate and maintain sufficient human resources to perform the essential services.
