Leprosy Mailing List – August 24, 2026
Ref.: (LML) Long-lasting adverse impact of chemoprophylaxis & what actually works.
From: Pieter AM Schreuder, Maastricht, the Netherlands
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Dear colleagues,
On August 3, 2026, Benedict Quao on behalf of the ILEP Technical Commission wrote a letter to LML called “Long-lasting adverse impact of chemoprophylaxis & what actually works”. In this letter he encouraged the LML readers to critically evaluate the evidence supporting the conclusion on Single Dose Rifampicin (SDR) as Post-Exposure Prophylaxis (PEP) presented in several letters to LML by Joel Almeida. Joel warns against the use of PEP and the justification of its use by ILEP. Benedict Quao stated that “While novel hypotheses are an important part of scientific progress, they should clearly be distinguished from conclusions supported by robust experimental or epidemiological evidence”.
This letter led to a particularly good, open and rich discussion in which experienced leprologists gave their opinion and led to one of the best discussions on PEP, the way the research has been done and what are the many important points which have not be taken into account when setting up this research. Every leprologist or those involved in leprosy research and leprosy control should at least read this exchange of opinion.
Joel Almeida, Claudio Salgado, Isabela Goulart and Ben Naafs took up the challenge and countered many of the arguments used by the ILEP Technical Commission. Wise words by Claudio Salgado to sidestep the arguments pro and contra with the following statement: “Rather than focusing exclusively on the proposed biological mechanism, I believe the discussion has now reached a broader and perhaps mort important scientific question: what level of evidence is required before a preventive intervention is considered sufficiently safe for widespread implementation?”.
After this first letter by Benedict Quao of 3-8-2026, the ILEP Technical Commission did not take part in the ensuing discussion. A few days ago Benedict even asked what happened with his letter. Apparently, nobody in the ILEP Technical Commission has followed this discussion or did not inform Benedict about it. We would like the reaction of ILEP to this thoughtful, open and scientific discussion.
We thank all who participated. Joel Almeida who as they say: "put a cat among the pigeons" and Benedict Quao who took up the challenge. Ben, Claudio and Isabela who delighted us with their critical remarks, showed us their wide experience in leprosy research over many decades and suggested ways to progress.
On behalf of the LML Board,
Pieter AM Schreuder
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LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << edit...@gmail.com
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