Table 1a.

All-embracing barriers and specific issues constraining vaccine development in low-and middle-income countries (LMCs).

ALL-EMBRACING BARRIER	SPECIFIC ISSUES
Financial and economic constraints	Economic restrictions worsened by COVID-19 pandemic Insufficient funding for scientific research and development (R&D) Low advocacy for vaccines budget
Political focus is short term	Politicians tend to favor near-term results, but investments in vaccine capabilities take years to bear fruit Easier to pursue near-term fill and finish manufacturing capabilities than investing in a long-term vaccine R&D strategy Changes in administrations and governments can cause shifting focus and funding
Over-reliance on Multinational Corporations (MNCs) and global actors	Historical reliance on MNCs and global actors as drivers of vaccine innovation was further accentuated during the COVID-19 pandemic Partnerships with MNCs are not balanced enough for MICs MNCs are not as focused on developing vaccines for NTDs
Competition from other health priorities	Vaccines compete against other health-related topics for limited funds and resources