We thank Murdoch and Levine for their editorial and brief summary of the problems surrounding acute respiratory infection (AR1) in the developing world. They make a good often repeated case for improved public health and vaccine-oriented interventions. This is however only part of the fight against ARI. Vaccine coverage particularly in the most remote areas is difficult just as is the provision of oxygen, the implementation of standard treatment guidelines and the adequate training and up-skilling of healthcare workers. These latter interventions do not receive anywhere near comparable funding and it is somewhat surprising that we are talking about new vaccines when oxygen is still not available or in limited supply, when standardized clinical guidelines such as the 'Pocketbook for the Hospital Care of Children' have not been implemented at scale. Donors and philanthropic organizations are courted for the latest vaccine, yet investment in capacity building would provide greater long-term gains, gains that look beyond the next demographic health surveys, gains that look long past Millennium Development Goals 4. It is well time we stop advocating clarion calls - a medieval trumpet heralding religious events - and instead advocate up-to-date proven interventions that have sustainability at their core.
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