Pneumonia is a global disease that is typically curable in developed countries but often fatal in developing countries. The global perception of pneumonia as a public health problem is emasculated by its familiar and benign image in the industrialized world. Pneumonia has no UN agency to highlight its importance and no fund or series of global networks to advocate for drugs, vaccines, or care. The ambiguity of its various acronyms (e.g., ARI and LRTI) further undermines its perception as a single, tractable problem. The vigorous response to SARS and the considerable support for pandemic influenza preparedness (~$10 billion) by the global public health community demonstrate what can be achieved when the world perceives a substantial health threat. Pneumonia, with a global burden of 5,000 childhood deaths every day, is a continuous, tangible threat that should trigger similar responses — action and research on pneumonia are urgently required.
Research on pneumonia is also very likely to be effective, especially if the problem is tackled comprehensively. A far-reaching approach should include (a) a better understanding of the etiology to help guide vaccine targets and antimicrobial therapy and to identify important atypical causes such as M. tuberculosis; (b) studies of pathogenesis and host response to improve case management and clinical outcome; (c) development of surveillance tools with new diagnostics to distinguish epidemics and identify novel pathogens; and (d) community-based studies to evaluate the impact of prevention and case management strategies, to describe the epidemiology of fatal pneumonia, and to investigate the role of equity in death from pneumonia in childhood.