[Current difficulties in leprosy control and proposals to foster the campaigns in French-speaking African countries].

In a great number of francophone African countries, Leprosy Control is failing. Early case finding and contact detection become deficient. Some countries, which have maintained multifunction mobile sanitary structures, issued from the French Service of Grandes Endémies Organization, record good results in Leprosy Control. The interest of early case finding is recalled, because 80% of new leprosy cases are discovered in systematic and periodic screening in non leprosy contact population. The Leprosy Control falling down reasons are reviewed and resolutions for improvement of existent health services are proposed. The priority should be given in strengthening of existent mobile services: either lightly multifunction teams under Grandes Endémies Service supervision nor itinerant medical workers based on dispensaries integrated in Health Primary Care structures. This strengthening must coexist with an increased contribution of general or private clinics and with a real information of sanitary and administrative authorities associated to good information of people. It is necessary that each African country choose a national leprosy medical officer for Leprosy Control. It should be better to follow example of some countries which have achieved some positive results in Leprosy Control by an operational strategy, adapted to African meaning, and sustained by the important aid of ILEP associations.