With the ongoing widespread circulation of avian H5N1 influenza viruses and the threat of pandemic influenza an ever-present reality, it is essential that those charged with protecting public health continue to focus intently on this urgent issue. As part of the response to this pandemic threat, research-based influenza vaccine manufacturers have made rapid progress with the research, development and testing of new vaccines and have greatly expanded their capacity to manufacture these products in the last few years. With the research and development phase now reaching completion, regulators have approved several prototype 'mock-up' pandemic vaccines and a number of 'prepandemic' H5N1 vaccines. As a consequence, the world is better prepared than it has ever been to counter an influenza pandemic. However, despite these advances, many policy, logistical and practical issues must be resolved for the population to benefit from these breakthroughs. In particular, the global community must establish the infrastructure required for population-wide immunization, secure appropriate vaccine supplies and undertake sufficient vaccine stockpiling to protect against the first wave of a pandemic.
