A surge in new leprosy cases in a remote region of Madagascar could not have come at a worse time. Once a prosperous vanilla-exporting town, Antalaha has suffered the economic consequences of two years of political instability that began with the March 2009 coup in which Andry Rajoelina, with the support of the military, deposed President Marc Ravalomanana. Numerous foreign aid and trade benefits on which the country was heavily reliant, particularly for the funding of social sectors, have since been suspended.