Na Primeira República (1889-1930) a lepra gradualmente adquiriu prioridade nas agendas estaduais e na federal, destacando-se o governo paulista na criação de um aparato nessa área. A relação entre filantropia e combate à lepra esteve associada às Sociedades de Assistência aos Lázaros e Defesa Contra a Lepra, criadas a partir da década de 1920. A criação do Ministério da Educação e Saúde Pública (1930), as reformas ministeriais e a gestão de Gustavo Capanema (1934-1945) redimensionaram o campo da saúde e o combate às doenças. O engajamento da Federação das Sociedades de Assistência aos Lázaros e Defesa Contra a Lepra (1932) na política ministerial de Capanema foi concretizada através da construção da rede preventorial em todo país. Ao final da Era Vargas, um aparato de saúde havia sido construído através de maciços investimentos e o isolamento compulsório das vítimas do mal de Hansen.During the First Republic (1889-1930) leprosy gradually gained priority in the state and federal governments’ agendas, with special emphasis being given by the São Paulo State government with the installation of specialized services in the area. The relation between philanthropy and actions taken against leprosy was associated with the Lazar Welfare Society and the Defense Against Leprosy Society, created in the nineteen twenties. The founding of the Ministry of Education and Public Health (1930), the ministerial reforms and the Gustavo Capanema administration (1934-1945) rearranged the health field and the approach to fighting diseases. The Federal Government’s commitment with the Lazar Welfare Society and the Defense Against Leprosy Society (1932) was obtained by means of Capanema’s ministerial policy and substantiated by the construction of a preventive network in the whole country. At the end of the Vargas Era, health installations had been built with massive investments and the compulsory isolation of victims of Hansen’s disease.