Leprosy was eliminated as a public health problem (EPHP) globally in 2000. Even after two decades over 200 000 cases are detected annually, clustered in certain populations and locations (India and Indonesia accounted together for 67.4%) and of them 9% were children and several with new disabilities. Human impact is amplified by the stigma caused by disabilities. Neglected Tropical Diseases (NTD) roadmap is prepared aiming at interruption of transmission of NTDs including leprosy and is grounded on the principles of equity, fairness and a commitment to the most vulnerable. Backed by evidence, multidrug therapy (MDT) was introduced in 1980s; the focus shifted from control to elimination. WHA resolution (1991) encouraged countries to expand MDT to reach EPHP. By 2000, registered prevalence reduced by 86% and EPHP was reached globally and after 10 years in SEA Region. EPHP gave wrong impression of eradication among policy makers and health staff which resulted in scaling back efforts in eliminating leprosy. MDT, a game-changer was inadequate to end transmission. Since 2006, the global leprosy strategies envisioned interruption of transmission through early detection, prevention with chemoprophylaxis and ending discrimination. This calls for concerted efforts in research, diagnostics, therapies, prevention, disability care and social support with equal emphasis on biomedical, social and environmental initiatives.