Prevalence rates for
leprosy have declined sharply over the past 20 y, with this decline generally attributed to the WHO multi-
drug therapy (MDT) campaign to provide free-of-charge treatment to all diagnosed
leprosy patients. The success of this program appears to have reached its nadir, however, as evidenced by the stalled decreases in both global prevalence and new case detection rates of
leprosy. Mass BCG vaccination for the prevention of
tuberculosis (TB) at national levels has had a positive effect on
leprosy decline and is often overlooked as an important factor in current
leprosy control programs. Because BCG provides incomplete protection against both TB and
leprosy, newer more effective TB
vaccines are being developed. The impact that application of these
vaccines will have on current
leprosy control programs is unclear. In this review, we assess the need for
vaccines within
leprosy control programs. We summarize and discuss
leprosy vaccine strategies that have been deployed previously and discuss those strategies that are currently being developed to augment recent breakthroughs in
leprosy control.