Since the 1920s, the medical community realized that the strategy of leprosy control based on segregation and persecution of patients was inefficient and expensive. In the 1930s the new liberal government incorporated leprosy within the general sanitary institutions, by merging the Bureau of Lazarettos and the National Department of Hygiene. The disease-apart approach started to be replaced by a more general public health strategy, which involved controlling other illnesses. Prevention and research played a more influential role, and the new sanitary officials saw leprosy in the light of the economic rationality of expenditures, placing more emphasis on therapies and making them mandatory for all patients. Improvements in leprosy treatment became widely known and available. However, the image of leprosy as a special condition and the practice of segregation were deeply entrenched within the Colombian culture and institutions. The rhetoric changed, but to break with several decades of persecution was a difficult task
Desde a década de 1920, a comunidade médica percebeu que o controle da hanseníase baseada na segregação dos pacientes era ineficaz e dispendiosa. Na década de 1930, o novo governo, mais liberal, incorporou a hanseníase às instituições sanitárias gerais, ao fundir o Serviço de Leprosários ao Departamento Nacional de Higiene. O isolamento começou a ser substituído por uma estratégia geral de saúde pública, que envolvia outras doenças. Prevenção e pesquisa foram valorizados , e as autoridades passaram a ver a hanseníase à luz da racionalidade econômica, enfatizando as terapias e tornando-as obrigatórias. Os avanços no tratamento tornaram-se largamente disponíveis. Entretanto, a imagem da hanseníase como doença especial e a segregação de seus doentes estavam profundamente arraigados na cultura e nas instituições colombianas. A retórica mudou, mas acabar com várias décadas de perseguição não foi tarefa fácil.
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