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 article provides an overview of global efforts to develop turmeric — a curry spice that is also used in a variety of Indian traditional remedies — into a modern therapeutic drug. The author highlights some of the hurdles to developing turmeric, including intellectual property barriers, turmeric's insolubility in water and its poor bioavailability. He also describes current efforts including ongoing lab and clinical trials.

This WHO report summarises the findings of a global survey on national policy and regulation of traditional medicine in 141 countries. It presents data on existing policies for traditional medicine and regulation of herbal medicines. The report highlights common hurdles to implementing these and provides a profile of each country surveyed.

According to the author of this review, only 7.4 per cent of complementary and alternative medicine (CAM) — which includes homeopathy and acupuncture — is evidence-based. The author evaluates research evidence from clinical trials and systematic reviews to reach this conclusion. By contrast, he says, more than half of all interventions in general internal medicine, and more than 65 per cent in psychiatry are based on sound evidence, including results from randomised controlled trials.

This review article outlines the basic principles of traditional Chinese and Indian medicine, and the differences in how these are being integrated into national health systems. The authors discuss progress in drug discovery including traditional medicinal plants and the role of supporting industries — from breeders to manufacturers — in commercialising traditional medicine.

This article, by integrative medicine expert Bhushan Patwardhan, highlights the role of traditional medicine in modern drug discovery. Patwardhan explains the driving forces behind efforts to mine traditional medicine for new drugs, outlines the different approaches that can be taken and provides examples of current efforts and success stories.

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 report, endorsed by the African Ministerial Conference on Science and Technology, analyses the obstacles to providing better access to, and ensuring local production of, medicines in low- and middle-income African countries.

It presents a map of innovation and access activities across the continent and offers a planning tool — the Pharmaceutical Innovation Framework and Grid — to help countries do self-assessments, develop strategies, build capacity and partnerships and improve access to essential medicines.

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 article, written by scientists from Canada, China, Egypt and India, examines the spread of alliances in health biotechnology and the extent of collaboration in this sector between the South and the North.

The authors surveyed 288 firms on South–North health biotech collaborations and use the results to map the extent and geography of partnerships. They analyse the international collaborations of firms in Brazil, China, Cuba, Egypt, India and South Africa and compare them to South–South collaborations.

The authors conclude that developing countries' firms are closely tied to northern health biotech networks and that South–North collaborations are common practice in health biotech. More than half the firms surveyed actively collaborate with countries in the North — compared to just a quarter working with other developing countries. Egypt is the only country where South–South collaborations outnumber South–North ones.

This paper proposes a model to provide better access to fairly priced antiretroviral (ARV) drugs for HIV-infected people in poor countries, while also safeguarding the interests of ARV manufacturers.

The authors explain what governments and brand and generic companies are doing to increase the availability of ARVs in developing countries, taking examples from Brazil, Canada, China, India, the United States and Thailand. They also discuss the implications of creating more South–South partnerships to produce and market ARVs; and the impact that the UNTAID–Clinton Foundation coalition has had on lowering ARV prices in developing countries.

The authors recommend an incentive-based strategy that includes international donors bulk-purchasing generic ARVs, individual governments providing financial relief packages for generic companies, and the WHO brokering negotiations between brand and generic companies.

Vaccination for infectious diseases is a vital method of prophylaxis, and has transformed modern medicine. By contrast, research into vaccines against chronic diseases has been less successful, in part because of the increased complexity involved.

In this opinion piece, the authors outline the prospects for the development of chronic disease vaccines. These might not need to rely on the traditional method of inducing the body to produce antibodies, but rather on introducing monoclonal antibodies against specific proteins — this has so far worked well against Crohn's disease and rheumatoid arthritis.

The authors outline key hurdles in developing a successful therapeutic vaccine. Safety and efficacy are two obvious ones, but there is a third that is unique to vaccines for chronic diseases. Because these vaccines would block bodily chemicals — such as cytokines or hormones — it would not be acceptable for a vaccine to induce a life-long block (unlike a malaria vaccine, for example, where a lifelong block would be ideal).

These might be particularly useful in developing countries, say the authors. Because prophylaxis with vaccines is already a familiar concept, there should be no problem with patients' compliance, and judicious partnerships between public and private organisations could mean the vaccines are produced cheaply.

This series of five articles outlines new challenges and unsolved problems since the journal's last series in 2005. The first article ([189kB]) predicts the disease burden and economic losses that developing countries would face from chronic diseases such as cardiovascular disease, cancer, chronic respiratory disease, and diabetes. In the 23 countries that the authors incorporated into a model, chronic disease was responsible for 50% of the disease burden in 2005. If no action is taken, they say, about US$84 billion of economic production will be lost from heart disease, stroke, and diabetes alone in these 23 countries between 2006 and 2015. The second article ([105kB]) looks at how to scale-up strategies to fight chronic diseases in developing countries. The authors review evidence to identify which methods are cost-effective and financially feasible, and therefore ready to be scaled-up.

Tobacco control, salt reduction (both of which are detailed in the series' third paper ([177kB])), and a multidrug strategy to treat individuals with high-risk cardiovascular disease (see an in-depth look in paper four ([220kB])) are prime candidates for scaling-up. What effect improving health systems has on the level of chronic diseases should be properly evaluated, say the authors. For some health interventions, such as preventing or controlling diabetes, there is little cost-effectiveness data for low or middle-income countries, but their scientific effectiveness is so compelling that countries should consider how best to incorporate them. The final paper ([92kB]) is a call to action to incorporate existing interventions into healthcare programmes, which in 2005 was costed at US$5.8 billion.

Launched to coincide with the 2004 International AIDS Conference in Bangkok, in this strategy document, the IAVI outlines plans to strengthen and expand the research and development pipeline of candidate HIV vaccines, and engage as partners those countries most affected by HIV/AIDS. Future scientific strategy includes focusing on vaccines that trigger neutralising antibodies, and understanding how live weakened vaccines work in animal models for clues to what is needed in a vaccine for protecting people.

In response to controversy over a trial in Cambodia that was halted earlier this year, this document, written for a broad audience, addresses a range of issues regarding tests of the antiretroviral drug tenofovir in healthy uninfected individuals. The clinical trials, taking place in Africa, Asia and the Americas, aim to see whether Tenofovir can protect against HIV infection in those who are at high risk of exposure to the virus — so-called Pre-Exposure Prophylaxis, or PREP. But its use raises a whole set of concerns regarding its potential impact on trial volunteers and their communities, including the prospects for encouraging drug-resistant strains of HIV to emerge and higher risk sexual behaviour.

This collection of 43 essays is by people involved in HIV/AIDS research, community education, clinical trials and advocacy, and aims to both inform and encourage global action. Written in an easy-to-read style, it introduces many of the major scientific, policy, social, ethical and economic challenges of developing an AIDS vaccine, with chapters covering issues such as HIV vaccine science, vaccine safety, ethics of clinical trials, informed consent, community action to encourage HIV vaccine development, and sources of information and help. Notable contributions from developing country authors include the personal experiences of a vaccine scientist involved in establishing the first HIV vaccine trials in Uganda, the vulnerability of women to HIV/AIDS in India , and the challenges of recruiting women to participate in clinical trials in Kenya. Illustrations include photographic accounts of the HIV virus and its life cycle, and clinical and laboratory tests on clinical trial volunteers.

This news feature aimed at a broad scientific audience likens the perplexing task of trying to develop an HIV vaccine to “flying without a compass”. HIV poses unique challenges, including its infinite variability and protective coating that masks it from antibodies, yet researchers have evidence from both human and animal studies suggesting that it may one day be possible to trigger an immune response that protects against infection.

A policy working paper concerning the demand for an HIV vaccine usefully compares studies conducted globally and nationally, concerning both public and private sectors, in order to help inform future healthcare strategies and financial planning, and investment from industry in HIV vaccine research and development.

This policy brief highlights key issues in assessing the demand for an HIV vaccine, including what factors influence demand, such as efficacy and cost of vaccine candidates and acceptability among target populations, and differences between public and private sectors in their willingness to pay for a vaccine and political commitment.