Major changes will impact the way national immunization programmes and services are planned and implemented over the next decade and beyond. This paper presents the most significant health policy contexts, the relevant features of health systems development and new prospects for service delivery. It outlines ways of transforming a dedicated disease control programme, polio eradication, for a broader health agenda. Progress anticipated in research for new vaccines and technologies is described. Reaching the new targets being established will require strong partnerships and the recent creation of the Global Alliance for Vaccines and Immunizations is an important step in this direction.