From leprosy to ground zero: Imagining futures in a world of elimination

Achieving a target of zero-zero disease, zero disability, and zero discrimination-has become the dominant focus of campaigns to control or eliminate diseases, from HIV/AIDS to malaria to leprosy. Given the historical failure of most eradication programs over the last century, such teleological imaginings of disease-free futures might seem overly utopian. But even if it were possible to eradicate such diseases in their entirety, would this be universally welcomed, even by those most affected by them? In this article, I compare the narratives of national and international bodies concerned with eliminating leprosy, in particular, with the more ambivalent narratives of those affected by the disease in India, the country where the disease is most prevalent. For the latter, the promise of elimination not only seems unrealistic, but represents a potential loss of identity. Imagining disease trajectories in less linear terms, I argue, might also nuance understanding of them.