Improvements in the coverage of leprosy elimination programmes have led to improved case detection and also to a steady increase in coverage with multi-drug therapy (MDT) from 76% to 91% in 1995. The large backlog of leprosy patients waiting for appropriate treatment has been reduced significantly and the gap between the number of estimated cases and the number of cases registered for treatment is steadily decreasing. However, it should be recognized that, in some countries, substantial numbers of patients do not have easy access to diagnosis and treatment; this could hamper the elimination of leprosy at the national and subnational levels in a number of highly endemic countries.