Access to thalidomide

Erythema Nodosum Leprosum (ENL) reaction is a serious and common complication of multibacillary leprosy. Thalidomide is an effective drug which can be used safely in the treatment of ENL, with due regard to its teratogenic potential. In many leprosy-endemic countries it is still not available to leprologists. In this editorial we discuss hindrance to access to thalidomide, and some considerations as to how to ensure its safe use in leprosy patients.