Pneumonia in Papua New Guinea, from the past to the future

This paper briefly describes a journey with pneumonia and the pneumococcus that began in partnership with Ian Riley at the Lae Hospital in 1967 and continues 43 years later. It is a journey that signalled the global emergence of penicillin-resistant pneumococci and played an important role in the licensure of pneumococcal polysaccharide vaccine for use in adults around the world. The journey involved many other people whose experience began in Papua New Guinea (PNG), playing lead roles in the global program to reduce pneumonia deaths in developing countries. But none of this has benefitted Papua New Guineans as it could and should have done. In this paper I assert that substantial benefits could now follow from widespread use of the 23-valent polysaccharide vaccine in PNG adults not suffering from HIV and that there is also good scientific reason why children over the age of 9 months should be offered the potential benefits from use of this vaccine that were demonstrated in PNG in the 1980s. Indeed there are very good medical and economic reasons why it should happen.