With over 350 vaccine candidates against 88 different pathogens, including HIV, now in development in academia and industry, this commentary, written for a broad audience, provides a broad overview of the current trends that will determine which candidates are most likely to reach the poor in developing countries. These include obstacles such as poor vaccine coverage with existing vaccines and a skewing of the vaccine industry away from producing vaccines against diseases that predominantly affect poor developing nations, and new organisations, funding initiatives and incentives, such as public private partnerships, that are now helping to overcome these obstacles.

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