 The development of new biotechnologies such as drugs, vaccines, devices or diagnostics requires a robust business case that considers scientific, technical, logistical, financial, and operational elements to determine feasibility and probability of success. The product value proposition plays a crucial role in establishing incentives for investment during and after development. This review aims to summarize the challenges in taking vaccines against neglected tropical diseases from development through licensure and provide a perspective that these vaccines can have measurable public health and economic profitability and market success. Understanding these processes and its challenges would accelerate and advance essential NTD vaccines towards licensure for delivery to afflicted populations in low and middle-income countries.