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<p>This review of pneumonia in the tropics is based on experience with respiratory infections in Papua New Guinea since the 1970s. It discusses ideas, principles, historical aspects of pneumonia research and the need to work with people in the community. In order to understand pneumonia in a tropical setting and evaluate new interventions it is essential to study the ecosystem of the causative infections, within the host and the community and between interacting microorganisms. Vaccines are much-needed preventive tools, and for pneumonia in a highly endemic setting the prevention of severe and fatal disease takes priority over the prevention of infection. In this setting mild infection plays an important role in preventing severe disease. For achieving long-term sustainable outcomes, sometimes ‘less is more’. A multipronged approach is required to control and prevent pneumonia, and in devising new ways of doing so. This includes appropriate and accessible clinical care, a clean, smoke-free environment, good nutrition and a range of vaccines. Also required are persistent advocacy from the global scientific community and strong engagement with and by the communities that bear the burden of disease. Better health care must be pursued in conjunction with raising literacy rates and reducing poverty</p>