Abstract More than 65% of the global rotavirus deaths were estimated to occur in 11 countries in Asia and Africa, claiming 345,000 children less than 5 years of age in 2004. While efficacious rotavirus vaccines are at hand, inequity in health delivery system within and between these countries was found to be the major hurdle against achieving the goal of rotavirus vaccine. When the coverage of currently used vaccines was applied to a rotavirus vaccine, a maximum of 202,550 deaths would be averted. Even if the coverage reached 80%, there would remain 96,841 children dying because of rotavirus diarrhea in these 11 countries. Studies are therefore encouraged to develop comprehensive strategies to resolve inequity in health delivery system enabling the increase in the immunization coverage.