Building and maintaining Amazon Machine Images (AMI's), if you need to customise them over the ones Amazon provide.
If you have a workload running across n+1 AWS accounts in n+1 AWS regions, then you need to build a production and distribution mechanism for your AMI's.
Surprisingly Amazon do not provide a mechanism for doing this. You're stuck with building AMI's on a per region or per AWS account basis. I do not believe you can build a single AMI and use it across your AWS Organization to date.