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Historically, Australia largely confined its few leprosy patients to remote leper colonies (leprosaria) or in quarantine hospitals. The Philippines and the Dutch East Indies (now Indonesia) had much larger infected populations in the early 20th century and required alternative approaches. The US military government of the Philippines chose actively to identify and confine all leprosy patients to segregated colonies on remote islands. Although intended to eliminate transmission by quarantine, the lack of effective chemotherapy to render patients non\u2010infectious meant that the census of patients (\u22485000) at the primary facility on Palawan climbed to the point that the colony could not be funded from the Health Department's budget. The Dutch government in the East Indies knew large leper colonies were unaffordable, so focussed segregation only in the capital Batavia and on plantations in Sumatra with the objective of minimising infection in the expatriate population. Neither approach was satisfactory largely due to resource constraints. Improved chemotherapy remains the best hope for the eventual elimination of leprosy.<\/jats:p>","DOI":"10.1111\/imj.70045","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T14:45:46Z","timestamp":1743691546000},"page":"677-681","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Different historical approaches to leprosy in the Asia\u2010Pacific"],"prefix":"10.1111","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5763-8660","authenticated-orcid":false,"given":"G. Dennis","family":"Shanks","sequence":"first","affiliation":[{"name":"Australian Defence Force Malaria and Infectious Disease Institute  Brisbane Queensland Australia"},{"name":"School of Public Health University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1917.02590530013008"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1489\/itl.1.1"},{"key":"e_1_2_6_4_1","first-page":"623","article-title":"Mycobacterium leprae: a historical study on the origins of leprosy and its social stigma","volume":"29","author":"Santacroce L","year":"2021","journal-title":"Infez Med"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)97781-5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1071\/MA20051"},{"key":"e_1_2_6_7_1","volume-title":"Leonard Wood and Leprosy in the Philippines: The Culion Leper Colony, 1921\u20131927","author":"Chapman RF","year":"1982"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2307\/j.ctv7h0tv5"},{"key":"e_1_2_6_9_1","volume-title":"Towards Zero Leprosy: Global Leprosy (Hansen Disease) Strategy 2021\u20132030","author":"World Health Organisation","year":"2021"},{"key":"e_1_2_6_10_1","volume-title":"An Army for Empire: The United States Army in the Spanish\u2010American War","author":"Cosmas GA","year":"1998"},{"key":"e_1_2_6_11_1","volume-title":"The Philippine War, 1899\u20131902","author":"Linn BM","year":"2000"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1923.s1-3.395"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/milmed\/160.1.32"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.70359\/bhc2005v030p010"},{"key":"e_1_2_6_15_1","first-page":"343","article-title":"Leprosy in the Philippines","volume":"31","author":"Higgins CM","year":"1933","journal-title":"US Nav Med Bull"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/shm\/hkz079"},{"key":"e_1_2_6_17_1","volume-title":"Kingdom of the Sick: A History of Leprosy and Japan","author":"Burns SL","year":"2019"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40249-020-00774-4"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-065369"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30703-X"}],"container-title":["Internal Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/imj.70045","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T10:17:15Z","timestamp":1746872235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/imj.70045"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1111\/imj.70045"],"URL":"https:\/\/doi.org\/10.1111\/imj.70045","archive":["Portico"],"relation":{},"ISSN":["1444-0903","1445-5994"],"issn-type":[{"value":"1444-0903","type":"print"},{"value":"1445-5994","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4]]},"assertion":[{"value":"2024-12-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}