In order to compete with these research-driven manufacturers, new manufacturers will need to invest in R&D, and their governments in an enabling environment to assure future opportunities for technology transfer. Thirdly, increased local vaccine production can lead to excess supply over demand. In the 1980s, this situation resulted in several vaccine manufacturers leaving the field and a transient shortage of some vaccines. In the case of seasonal influenza vaccine, the advantages in terms of health security of establishing more geographically balanced production capacity for pandemic vaccine are considered to outweigh the risks posed by excess capacity. The consultation concluded that,

given limited production capacity, technology transfer − is cost-effective and and the hub model Bcr-Abl inhibitor where appropriate − is cost-effective and should be considered for new vaccines such as conjugate pneumococcal or dengue vaccines in order to ensure universal access to immunization in developing countries. In the last decade, the threat of highly pathogenic

avian influenza viruses to populations, health systems and socioeconomic infrastructures compelled governments across the world to increase their preparedness for the next such emergency. Public health agencies, research institutions, the pharmaceutical industry and major development partners are among those that responded rapidly to the alarm. WHO Member States reinforced the importance of health security see more in policies and guidelines such as the updated International Health Regulations (2005), and through innovative strategies

such as the WHO initiative to increase influenza vaccine production capacity in developing countries. Overall progress of the 11 grantee vaccine manufacturers towards their specific objectives has been impressive (results of the six manufacturers awarded grants in the first round of proposals are detailed in their respective articles published in this supplement). Within a short period of time, three manufacturers have registered a seasonal or pandemic vaccine with their national regulatory authorities, even though two of these had no prior knowledge of influenza Ribonucleotide reductase vaccine production. Several more have reached the late stages of clinical evaluation. Supported by a solid monitoring and evaluation programme (see article by Francis and Grohmann), WHO has contributed to increased global influenza vaccine production capacity for more equitable access to a life-saving vaccine during a pandemic. Although the severity of the 2009 H1N1 pandemic was characterized as moderate, there is no room for complacency, as increasing numbers of human cases of H5N1 influenza are being reported in several countries. Support should therefore be maintained to the current grantees and expanded to new manufacturers to allow them to complete or initiate their technology transfer projects.