Vaccine production is now at the heart of the debate on development. This paper argues that, as well as economic policies to address market failures, development policies aimed at fostering vaccine innovation should also consider the institutional and organisational uncertainties. The International Aids Vaccine Initiative (IAVI), a product development PPP, is attempting to increase vaccine production for neglected diseases by acting both as a broker and integrator of knowledge. Within IAVI and perhaps other PPPs there is a related tension between an emphasis on private pharmaceutical sector efficiency and sustainable development activities that requires understanding and managing if PPPs are to successfully reach their goals.