The Principles of Disease Elimination and Eradication
"The indicators of eradicability were the availability of effective interventions and practical diagnostic tools and the essential need for humans in the life-cycle of the agent. Since health resources are limited, decisions have to be made as to whether their use for an elimination or eradication programme is preferable to their use elsewhere. The costs and beneflts of global eradication programmes concern direct effects on morbidity and mortality and consequent effects on the health care system. The success of any disease eradication initiative depends strongly on the level of societal and political commitment, with a key role for the World Health Assembly. Eradication and ongoing programmes constitute potentially complementary approaches to public health. Elimination and eradication are the ultimate goals of public health, evolving naturally from disease control"
"Elimination and eradication of human disease have been the subject of numerous conferences, symposia, workshops, planning sessions, and public health initiatives for more than a century."
"the science of eradication, with the understanding that the present Atlanta Conference would address specific candidate diseases for elimination or eradication in the context of global health strategies."
"Eradication has been defined in various ways -- as extinction of the disease pathogen (3), as elimination of the occurrence of a given disease, even in the absence of all preventive measures (4), as control of an infection to the point at which transmission ceased within a specified area (5), and as reduction of the worldwide incidence of a disease to zero as a result of deliberate efforts, obviating the necessity for further control measures (1)"
"In theory if the right tools were available, all infectious diseases would be eradicable. In reality there are distinct biological features of the organisms and technical factors of dealing with them that make their potential eradicability more or less likely. Today's categorization of a disease as not eradicable can change completely tomorrow, either because research efforts are successful in developing new and effective intervention tools or because those presumed obstructions to eradicability that seemed important in theory prove capable of being overcome in practice."
"The costs and benefits of global eradication programmes can be grouped into two categories -- direct effects and consequent effects. The direct effects of eradication are that no morbidity or mortality due to that disease will ever again occur. Control programmes can cease. The consequent effects are those that impact positively and negatively on the entire health care system"
"Political commitment must be gained at the highest levels, following informed discussion at regional and local levels. A clear commitment of resources from international sources is essential from the start. A resolution by the World Health Assembly is a vital booster to the success of any eradication programme."
"Eradication programmes are attractive to potential funding sources because they establish high standards of performance for surveillance, logistics, and administrative support; develop well-trained and highly motivated health staff; assist in the development of health services infrastructure including, for example, mobilization of endemic communities; and provide equity in coverage for all affected areas, including urban, rural, and even remote rural areas. They also offer opportunities for other health benefits (e.g. for dracunculiasis eradication: health education and improved water supply), improved coordination among partners and countries, and dialogue across frontiers during war."
"Eradication programmes consume major human and financial resources."
"elimination and eradication programmes are laudable goals, but they carry with them an awesome responsibility. There is no room for failure. Careful and deliberate evaluation is a prerequisite before embarking on any programme. Elimination and eradication are the ultimate goals of public health. The only question is whether these goals are to be achieved in the present or some future generation."
https://www.cdc.gov/mmwr/preview/mmwrhtml/su48a7.htm
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