Streptococcus pneumoniae, the pneumococcus, is a ubiquitous human respiratory bacterial pathogen, well known for its association with pneumonia and meningitis. It causes disease in all age groups, particularly at the extremes of infancy and old age and is a major cause of morbidity and mortality in the tropics. The pneumococcus is the leading cause of acute lower respiratory infections, which are an important cause of death and the principal cause of global morbidity assessed in disability adjusted life years.^[1] In addition, the epidemiology of pneumococcal infection in many regions of the tropics has been profoundly altered by the interaction of the pneumococcus with the human immunodeficiency virus, leading to a much increased disease burden. Antibiotic resistance amongst pneumococci continues to evolve and this threatens to undermine the basic principles of affordable management.

Set against these concerns has been a renewed …