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The big three pathogens—Haemophilus influenzae type b, Neisseria meningitidis (meningococcal), and Streptococcus pneumoniae (pneumococcal)—are responsible for a considerable share of endemic and epidemic meningitis globally. [...]this fact is bittersweet: during the same period, the decreases in death rates from other vaccine-preventable diseases, such as measles (a 93% decrease) and tetanus (91% decrease), dwarf the progress made in preventing deaths from meningitis.3 Incidence of and deaths due to pneumococcal meningitis (the largest cause of years of life lived with disability among survivors) decreased over time, again attributable to increased widespread availability of polyvalent pneumococcal vaccines.1 Pneumococcal conjugate vaccines can result in herd immunity by preventing nasopharyngeal carriage of the bacteria targeted by the vaccine, although bacteria not covered by the vaccine are not affected, highlighting the need for continued work on even more multivalent pneumococcal vaccines. The GBD 2016 Meningitis Collaborators astutely note barriers to the control of meningitis in resource-limited areas, including limited capacity for CSF analysis, the challenge of making a clinical diagnosis of meningitis in neonates and young children, and limitations in laboratory diagnostics that can be done on site.1 In addition to the focus on implementing aggressive vaccination campaigns, attention should be paid to addressing these other challenges.