<P> Japan still has sanatoriums (although Japan's sanatoriums no longer have active leprosy cases, nor are survivors held in them by law). </P> <P> The importance of the nasal mucosa in the transmission of M leprae was recognized as early as 1898 by Schäffer, in particular, that of the ulcerated mucosa . </P> <P> British India enacted the Leprosy Act of 1898 which institutionalized those affected and segregated them by gender to prevent reproduction . The Act was difficult to enforce but was repealed in 1983 only after MDT therapy had become widely available . In 1983, the National Leprosy Elimination Programme, previously the National Leprosy Control Programme, changed its methods from surveillance to the treatment of people with leprosy . India still accounts for over half of the global disease burden . </P> <P> Between 1995 and 1999, the WHO, with the aid of the Nippon Foundation, supplied all endemic countries with free MDT in blister packs, channeled through ministries of health . This free provision was extended in 2000 and again in 2005, 2010 and 2015 with donations by the MDT manufacturer Novartis through the WHO . In the latest agreement signed between the company and the WHO in October 2015, the provision of free MDT by the WHO to all endemic countries will run until the end of 2020 . At the national level, nongovernment organizations affiliated with the national program will continue to be provided with an appropriate free supply of this WHO - supplied MDT by the government . </P>

Where is leprosy most commonly found in the world