A review of estimated coverage with three doses of diphtheria, tetanus, pertussis vaccine (DTP3) suggests many countries will not meet the Global Immunization Vision and Strategy (GIVS) goal to increase national immunization coverage levels to at least 90% by 2010 and to sustain these levels through at least 2015. In fact, 42% of low-income countries have made insufficient or no progress towards the goal, compared to 8% of high-income countries. Despite enormous and increasingly successful efforts to address the global burden of vaccine-preventable diseases and extraordinary improvements in universal childhood immunization, opportunities remain to improve routine immunization coverage globally.