Disease eradication: where are we at now?

Thirty years on, smallpox remains the only human disease to have been eradicated, despite relentless efforts to get rid of others.

In the late 1980s, guinea worm eradication was scheduled for 1995 and polio for 2000 — but they are still with us. And efforts to eradicate malaria dating back to 1955 had similarly failed by the 1960s when researchers realised that mosquitoes were developing resistance to DDT, the environmentally-hazardous pesticide.

Following 30th anniversary celebrations to commemorate the eradication of smallpox, scientists met in Frankfurt, Germany, in August 2010 to discuss challenges for the ongoing eradication campaigns and the future feasibility of disease eradication, at the 'Disease Eradication in the Context of Global Health in the 21st Century' meeting.

They concluded that new eradication plans must be more evidence-based and that there should be an analysis of the costs and benefits, a thorough funding plan, and new financial tricks to prevent perennial budget gaps like those hampering the polio campaign.

Any new eradication programme should also help poor countries build stronger health systems along the way, the meeting agreed.

Today there are eradication programmes for polio, lymphatic filariasis and guinea worm. Measles might be next on the list when the World Health Assembly meets in Geneva in May, following an expert group conclusion in August that "measles can and should be eradicated" and a report commissioned by the WHO that found that measles eradication would cost US$7–14 billion but would save more.

But, before new diseases are earmarked for eradication, donors and decision makers are waiting to see how the current ones, especially the polio campaign, progress.

"I'm very worried about polio," said Hopkins. "It must succeed. If it didn't, it would be a big setback for the whole concept of eradication."