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In the last decade, research on childhood pneumonia and acute lower respiratory infection (ALRI), one of the most common causes of child deaths globally, has progressed in many directions, with support from global agencies, including the WHO, private foundations and with many local initiatives. Research on conjugate pneumococcal vaccines has involved different schedules. 1 2 There have been large aetiology studies, including highlighting the role of viruses, especially respiratory syncytial virus (RSV) in ALRI 3 , the primacy of the pneumococcus, and the lesser but significant role of Klebsiella in deaths from both hospital- and community-acquired pneumonia. 4 There have been many trials and implementation studies proving the value of the RSV monoclonal antibody nirsevimab 5 and its real-world impact 6 especially in high-income countries. And in low-income settings, studies of the prevalence of hypoxaemia in pneumonia 7 and large field trials of the implementation of oxygen therapy. 8 9 In the previous decade, WHO supported large trials in South Asia of oral antibiotics and outpatient treatment of ALRI.