In 2005, before most low- and middle-income countries started vaccinating children routinely for pneumococcal disease, it caused approximately 1.5-million deaths worldwide annually.

About 700,000 to 1-million of these deaths were in children under five years. Pneumococcal disease occurs when Streptococcus pneumoniae invades a normally sterile area of the body, causing meningitis, pneumonia, septicaemia or other disease syndromes. Case fatality rates are very high for septicaemia (>20%) and meningitis (>50%) in low- and middle- income countries...

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