The Lancet Infectious Disease
Jul 2009  Volume 9  Number 7   Pages 393 – 454
http://www.thelancet.com/journals/laninf/issue/current

Protecting children with HIV against pneumococcal disease
Andrea Meehan, Grant Mackenzie, Delane Shingadia, Robert Booy

Rwanda has become the first developing nation to introduce pneumococcal conjugate vaccine. The aim is to vaccinate nearly all Rwandan infants by the end of 2009. However, equally at risk older children with HIV are unfortunately not yet on the agenda.1 WHO estimates that disease due to Streptococcus pneumoniae claims the lives of up to 1 million children every year.2 These deaths are disproportionately represented in the developing world, particularly in children infected with HIV3 of whom there are about 2 million in sub-Saharan Africa alone.