Over the past few years, the advent of several preventive interventions finally provides opportunities to address the burden of respiratory syncytial virus disease. However, in the past, new vaccines to prevent important respiratory illnesses were authorised and implemented first in high-income countries (HICs) and much later in LMICs. Adoption in LMICs lags unacceptably behind. Several barriers preclude the successful delivery of respiratory syncytial virus preventives in LMICs, including low awareness; a lack of country-specific burden data; logistical, administrative, and structural constraints; and the cost of the products. The first step must be equitable access to new interventions.