The unprecedented scale and dissemination of emerging infectious diseases pose new challenges for global public health. Infections such as invasive pneumococcal disease, SARs-Cov-2, meningococcal meningitis and other pathogens are devastating for those not protected by vaccines. Outbreaks often turn into crises due to lack of available, affordable, resource-appropriate vaccines. Many of the vaccines that are available are unable to meet specific cost and infrastructure requirements, especially in low and middle-income countries. Vaccine manufacturing and distribution is complex, costly and challenging. Yet, the ultimate success of efforts to bring the current and any future emerging infectious disease global pandemics to a close will depend on access to vaccines and vaccination in low- and middle-income countries.