The development and introduction of new vaccines is a costly and time consu
ming process. Unfortunately, those most in need -individuals in developing
countries- are the last to receive these powerful disease preventing produc
ts. From the time a vaccine is first licensed in a developed country to the
time most of the poor ill developing countries have access to the vaccine
can be 20-30 years. This delay is unacceptable. There is a great need to re
duce this time span. This paper examines five ways of reducing the time spa
n. Each of the five is essential and achieving success on all five will req
uire a heightened level of international effort and coordination. (C) 1999
Elsevier Science Ltd. All rights reserved.