The past few years have seen renewed attention focused on the persistent burden of childhood mortality globally. Of the 10.6 million deaths of children under 5 every year, the vast majority occur in a mere 42 countries of the developing world. It is also apparent that despite advances in understanding the pathophysiology and significance of the major causes of child death, most of the known killers such as diarrhoeal disorders and acute respiratory infections (ARI) still continue to take a heavy toll.¹

Most of the deaths from ARI are due to pneumonia. The annual incidence of pneumonia is estimated at 151 million new cases per year, of which 11–20 million (7–13%) cases are severe enough to require hospitalisation.² Serious neonatal infections account for 30–50% of neonatal mortality in different regions and it is difficult to disentangle sepsis and deaths from pneumonia. With the inclusion of neonatal pneumonia, recent estimates indicate that pneumonia is the single largest contributor to child mortality, accounting for almost 28–34% of all under-5 deaths globally.³ It is also important to note that in contrast to diarrhoeal deaths where mortality rates have reduced dramatically, despite the introduction of a global programme for the control of ARI almost 15 years ago, there has been little change in overall burden of deaths from pneumonia. Figure 1⇓ shows estimates …