The great advances in vaccine R&D over the last 20 years have not been paralleled by the regular introduction of new vaccines into the market thus far. This situation acquires more dramatic proportions in developing countries, where preventable infectious diseases still impose a major public health problem. Furthermore, most of the now developments are being conceived to target the market of industrialized countries and it is foreseeable that their introduction in low-to-middle income countries will be difficult if at any time possible. Strengthening their own capacities for R&D and production is likely to be the most reasonable avenue to ensure that new vaccines will become a sustainable reality for developing countries. Concerted efforts that draw together local capacities (industry and academy) with the experience of large global manufacturers, could have a major impact and provide a great example of an effective partnership to achieve this.