In a landmark achievement for global public health, Chile has been officially verified by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) as having successfully eliminated leprosy (Hansen’s disease). This accomplishment makes Chile the first nation in the Americas—and only the second globally, following the Hashemite Kingdom of Jordan—to achieve this rigorous public health milestone.
The verification process, conducted by an independent expert panel in 2025 at the request of the Chilean Ministry of Health, represents the culmination of more than three decades of persistent surveillance, robust clinical infrastructure, and unwavering political commitment. By achieving this status, Chile provides a blueprint for how nations can overcome ancient, stigmatized diseases through a combination of scientific rigor, inclusive social policy, and sustainable health systems.
A Legacy of Resilience: The Chronology of Elimination
Leprosy, a chronic infectious disease caused by the bacterium Mycobacterium leprae, has historically been one of the world’s most feared conditions. In the Chilean context, the disease was first documented in the late 19th century on Rapa Nui (Easter Island). For decades, the disease was largely contained to this remote region, where authorities implemented strict isolation and treatment protocols.
By the late 1990s, the final secondary cases on Rapa Nui were successfully managed, effectively halting the local transmission cycle. A critical turning point occurred in 1993, which marked the last reported instance of a locally acquired case of leprosy in Chile.
However, rather than declaring "mission accomplished" and dismantling the relevant health infrastructure, Chile chose a path of sustained vigilance. For over 30 years, leprosy remained a notifiable condition. The country integrated leprosy monitoring into its broader public health surveillance, ensuring that the health system remained in a state of "clinical readiness." This institutional memory proved essential, as it allowed the country to continue identifying and treating sporadic cases—primarily among individuals who contracted the disease outside of Chile—without allowing the infection to take root again in the domestic population.
Data-Driven Success: The Surveillance Model
The verification of leprosy elimination is not merely a symbolic gesture; it is a clinical determination based on the absence of locally acquired transmission over a prolonged period. Between 2012 and 2023, Chile recorded 47 cases of leprosy nationwide. Crucially, every single one of these cases was imported, meaning the individuals acquired the infection abroad before entering the country.
This low-incidence environment presents a unique challenge: when a disease becomes rare, health professionals may go their entire careers without encountering a single patient. To combat this, Chile implemented an integrated, tiered care model. Primary health centers serve as the front line, where staff are trained to identify the early symptoms of leprosy—such as skin lesions and peripheral nerve involvement. These centers then coordinate with specialized dermatology services to confirm diagnoses and initiate multidrug therapy (MDT).
This model aligns closely with the WHO’s "Towards Zero Leprosy" strategy, which emphasizes early detection to prevent the permanent nerve damage, disabilities, and social stigma that often accompany the disease. By providing holistic care—including physiotherapy, rehabilitation, and long-term support—Chile has ensured that patients not only recover physically but also remain integrated into society.
Official Perspectives: Leadership and Solidarity
The international community has lauded Chile’s achievement as a paradigm-shifting event for the Western Hemisphere.
"This landmark public health achievement is a powerful testament to what leadership, science, and solidarity can accomplish," stated Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. "Chile’s elimination of leprosy sends a clear message to the world: with sustained commitment, inclusive health services, integrated public health strategies, early detection, and universal access to care, we can consign ancient diseases to history."
Dr. Jarbas Barbosa, Director of the Pan American Health Organization, emphasized the broader implications of this success. "Chile’s achievement demonstrates that eliminating leprosy is achievable and requires building strong systems that can detect, respond to, and provide comprehensive care for people affected by the disease," Dr. Barbosa noted. "Being the first country in the Americas to be confirmed as eliminating leprosy sends a powerful message to the Region: that diseases strongly linked to groups living in vulnerable conditions can be eliminated, contributing to interrupt the vicious circle between disease and poverty."
Ximena Aguilera, Chile’s Minister of Health, reflected on the pride felt across the nation. "This milestone reflects decades of sustained public health efforts, including prevention strategies, early diagnosis, effective treatment, continuous follow-up, and the commitment of health teams across the country. It also reaffirms our responsibility to maintain active surveillance and ensure respectful, stigma-free care for all."
The Infrastructure of Elimination: Global Partnerships
The success of the Chilean model is inextricably linked to international cooperation and the availability of essential medicine. Since 1995, PAHO and the WHO have ensured that countries across the Americas have an uninterrupted supply of multidrug therapy (MDT).
This logistical achievement was made possible through strategic partnerships with the private sector and philanthropic organizations. Specifically, The Nippon Foundation (1995–2000) and Novartis (from 2000 onwards) have provided MDT free of charge through direct agreements with the WHO. This reliable, cost-free access to medication has been the bedrock of the region’s ability to cure patients and prevent the transmission of the bacteria.
Beyond medicine, PAHO has played a vital role in technical assistance, helping Chile align its surveillance systems with international standards, strengthening laboratory capacities, and maintaining a high level of clinical expertise even in the face of dwindling case numbers.
Implications for Public Health and Human Rights
Chile’s elimination of leprosy is not just a clinical victory; it is a triumph of policy and human rights. Leprosy has historically been a disease of the marginalized, often resulting in systemic discrimination. Chile’s success was achieved within a legal and social framework that guarantees equal access to health care, disability services, and social protection.
By integrating care into its general health system, rather than creating specialized, isolated clinics, Chile has effectively reduced the stigma associated with the disease. The country’s public-private health system, supported by strong regulatory oversight, has ensured that even the most vulnerable populations, including migrants, have access to the necessary care, preventing the creation of "blind spots" in the health surveillance network.
Sustaining the Future: The Post-Elimination Phase
Achieving the status of "eliminated" does not mean that the disease will never reappear; it means that the country has the systems in place to prevent it from becoming a public health crisis again.
As Chile enters the post-elimination phase, the focus shifts to maintaining "sensitive surveillance." The verification panel has recommended several key actions to ensure long-term success:
- Continued Reporting: Maintaining transparent and regular reporting to the WHO.
- Clinical Retention: Utilizing the WHO Academy’s online training modules to ensure that even as the disease fades from clinical practice, the next generation of healthcare workers remains knowledgeable about detection and treatment.
- Referral Centers: Formally designating specific referral centers to act as hubs for expert knowledge and specialized care should any future cases emerge.
Conclusion: A Blueprint for the Americas
Leprosy continues to affect more than 200,000 people globally every year, remaining endemic in over 120 countries. As part of its 2021–2030 roadmap for neglected tropical diseases, the WHO has set ambitious targets to control, eliminate, and eradicate these conditions.
Chile is now the 61st country globally and the 6th in the Americas to have eliminated at least one neglected tropical disease, joining the ranks of nations like Brazil, Colombia, Ecuador, Guatemala, and Mexico. By becoming the second country in the world to eliminate leprosy, Chile has set a new standard for the region.
The lesson from Santiago is clear: disease elimination is not a destination, but a process of building resilient, inclusive, and well-funded health systems. By prioritizing equity and science, Chile has proven that even the most ancient and persistent diseases can be relegated to the history books, providing a beacon of hope for the millions still suffering from neglected tropical diseases worldwide.
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