This special issue of the journal Philosophical Transactions of the Royal Society B: Biological Science explores how vaccines can fulfil their full potential for addressing global health challenges. It charts the progress to date, reviewing successes as well as challenges in the development and distribution of both human and veterinary vaccines.

The articles describe how vaccines can help mitigate and treat the world's major infectious diseases such as malaria, tuberculosis and HIV/AIDS, as well as chronic diseases, such as cancer. They explore vaccine policy and financing, ways to accelerate the development of new vaccines, issues surrounding public acceptance, and the logistics of getting vaccines to where they are needed. Also discussed is the use of vaccines to treat diseases in livestock — making an important link between health interventions, agricultural output and economic consequences.

The papers in this issue were presented at the meeting, 'New vaccines for global health', held at the Royal Society in London, United Kingdom, in November 2010.

This report makes a case for the importance of antimalarial drug monitoring as an integral part of disease surveillance programmes in developing countries. Antimalarials are some of the most commonly counterfeited drugs — the high prevalence of malaria translates to a large consumer market in the developing world. The problem is serious in South-East Asia but is expected to become significant in African countries too. The report suggests that scientists ensure drugs are genuine and of a good quality before conducting efficacy or resistance studies in areas where counterfeits circulate widely.

Too few effective antimalarials and poor use of bednets are two main reasons offered for why malaria still kills millions every year. This systematic review suggests that social and cultural factors in tackling malaria are often ignored. For example, many people in the developing world still use traditional medicine to treat malaria, which is often blamed on spiritual problems or curses, and can be a barrier to effective treatment.

This article from The Lancet provides useful background information on Chagas disease including its transmission, epidemiology, pathogenisis, diagnosis and treatment. The disease affects eight million people in Latin America and poses a growing health problem in non-endemic areas due to increased trade and travel.

This report gives an overview of progress in developing an HIV/AIDS vaccine, including new adjuvant strategies, novel vectors for antigen delivery and presentation, and alternative ways of eliciting antibody responses. The authors call for continued commitment to basic research to identify an effective and affordable HIV vaccine.

This Nanomedicine paper reviews a range of strategies based on nanotechnology that are currently being used or tested to improve HIV/AIDS treatment and prevention. The authors review nanomedical advances in antiretroviral therapy, gene therapy, immunotherapy, vaccines and microbicides.

They conclude that nanotechnology promises great improvements in all of these areas but they warn that the field still faces many challenges including the toxicity of nanomaterials, their stability in physiological settings and the question of how to mass-produce them.

This paper explains how interdisciplinary collaboration in health, nutrition, and agriculture has helped the Millennium Villages Project in 12 African villages meet the Millennium Development Goals.

Global science is increasingly under pressure to become more interdisciplinary. Econutrition is a good example of a cross-sector concept that joins environmental and human health, focusing on crosscutting areas such as agriculture and ecology.

Soil erosion and decreasing biodiversity causes environmental damage that lowers food production. A lack of food results in malnutrition and illness that, in turn, lead to poorer labour productivity and poorer agricultural management.

The Millennium Villages Project emphasises community engagement and leadership, and the case study from the Nyanza Province near Lake Victoria in Kenya illustrates that this can work well in improving nutrition.

One-fifth of adults in the area have HIV and many have malaria and TB. People in the region go hungry for up to seven months a year and are malnourished. The villagers constructed a health clinic and organised teams of community healthcare workers trained in nutrition.

Farmers receive fertilisers and plants if they donate ten per cent of their harvest towards a school lunch programme that concentrates on providing missing nutrients. For example, by adding local crops such as sweet potatoes common vitamin A deficiencies are eliminated. The key to success, say the authors, is to ensure that farmers are supported, especially in producing a variety of crops.

This journal article describes the first climate-based model used to predict outbreaks of dengue fever. Researchers from the University of Miami and the University of Costa Rica used climate data and vegetation indices from Costa Rica to predict disease outbreaks with 83 per cent accuracy.

Globally, there are up to 100 million cases of dengue fever, and its more dangerous form, dengue haemorrhagic fever, every year. The spread of dengue fever is set to rise as the world's climate changes. The importance of this model is that it could be used as the basis for an early warning system to prevent the spread of the disease by warning populations that are at risk.

The indices used in the model include variables such as El Niño Southern Oscillations and sea surface temperature, which affect populations of the Aedes aegypti mosquito that spreads the infection.

A population's immunity to disease can greatly affect outbreaks of vector-borne disease, and isolating the influence of climate variability has proven difficult. This research study sets out to evaluate the effect of climate by accounting for population immunity.

The authors collated data on cholera cases from a predominant strain in the rural area of Matlab, Bangladesh, from 1966–2002. They used a model to incorporate immunity from previous infections and also potential cross-immunity from previous infections by other strains. They found that both forms of immunity were long-lasting — over 10 years in some cases. Yet the variation in transmission did not always match variations in immunity; at several points, it coincided with severe weather change such as monsoon rains or river overflow.

The authors suggest that forecasting disease will require considering climate variability alongside population susceptibility.

This article, written by the WHO Rapid Pandemic Assessment Collaboration and published in the journal Science, examines the spread of A(H1N1) influenza, or 'swine flu', and assesses its potential to cause a pandemic.

Analysing surveillance data from Mexico, the authors suggest the geographical spread of swine flu will likely be comparable to other twentieth century pandemics, although the associated impact on human health is difficult to predict.

The authors suggest that the outbreak originated in mid-February 2009 in the village of La Gloria, Veracruz, where over half the population suffered acute respiratory illness. They calculate that the virus transmissibility — the number of cases that one case generates on average — is between 1.4 and 1.6, similar to the transmissibility of previous flu viruses including those that led to the 1918, 1957 and 1968 pandemics. The authors estimate that by 30 April 2009, 6,000–32,000 people will have been infected, with 0.4–1.4 per cent of cases being fatal.

This series of commentaries and research articles — published by The Lancet, the Peking University Health Sciences Centre and the China Medical Board — addresses China's major health challenges, strategies and future. It has been produced by a group of 63 scientists from 10 countries with Chinese scientists making up two-thirds of the authors.

The research papers give scientific evidence on key health issues including the emergence and control of both infectious and chronic non-infectious diseases in China as well as the performance of China's healthcare system.

Authors of the series' commentaries further discuss a range of topical issues affecting China's health system, including the state of biomedical science and technology (see 'Progress in Chinese biomedicine a massive challenge'), medical research ethics, the lessons learnt from China's schistosomiasis control programme and the challenges the country faces in controlling HIV/AIDS.

The so-called 10/90 gap in health research — which refers to the fact that only about 10 per cent of funding is targeted to diseases which account for 90 per cent of the global disease burden — is a well recognised phenomenon which is being targeted by a number of initiatives. This article, by members of the Drugs for Neglected Diseases Working Group at Médicines Sans Frontières, analysed the outcomes of pharmaceutical research and development over the past 25 years and reviewed current public and private initiatives aimed at addressing the lack of research into controlling important infectious diseases in developing countries.

The authors found that of nearly 1400 new drugs marketed between 1975 and 1999, only 16 were for tropical diseases and tuberculosis (all of which had been developed with public-sector involvement). There is a 13-fold greater chance of a drug being brought to market for central nervous system disorders or cancer than for a neglected disease.

The authors conclude that there is no indication that drug development for "non profitable" infectious diseases will significantly improve in the near future and that new strategies are required to stimulate such development. They argue that a sustainable solution will require the establishment of an international pharmaceutical policy for all neglected diseases. Private sector research obligations should be explored further, and public sector not-for-profit research capacity promoted, particularly for the most neglected diseases.

(Free registration with The Lancet is required to view this article.)