Global Disease Eradication:  The Race for the Last Child

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About the Book

In the fall of 1977, the world health community recorded what was considered the very last case of naturally transmitted smallpox on Earth. Three years later, the world was declared officially free of this deadly infectious disease. This event marked what some view as one of the most remarkable achievements of modern science.

Global Disease Eradication is in part about the smallpox victory and the end game that followed, but it is also a look into the debate surrounding global disease eradication, a goal that many in the world health community see as the ultimate achievement of public health.

The authors present the history of three separate campaigns to eradicate a major infectious disease worldwide. The first, against malaria, though undertaken with ambition and optimism, ultimately failed: at the beginning of the 21st century, malaria threatens the health of over 2,400 million people worldwide. In contrast, the campaign against smallpox succeeded for a wide variety of reasons. Now public health workers are within a hair's breadth of eradicating polio -- the third campaign -- but tremendous uncertainties still surround the effort.

Whether these monumental global campaigns should be undertaken remains an open question. What is the value of global disease eradication if, as with smallpox, it ultimately leaves the world's population susceptible to accidental or intentional reintroduction of the disease? What are the costs of an eradication program, both direct and indirect, as resources are funneled into a single purpose at the cost of other priorities? What are the challenges involved in actually stopping a disease in its tracks?

Needham and Canning contribute a clear evaluation of the social, political, scientific, and economic considerations, both for the three specific campaigns described and for all future efforts toward protecting every child worldwide for deadly infectious diseases.

Global Disease Eradication: Race for the Last Child is available through,, and


Eradication: a Prologue

Malaria and the Magic Bullet

Two Children
Swamps, Farms, and Bad Air
Escalating Pressure
Learning from the Past: Hard Lessons, Hard Work
Biology Plays Its Hand
Social Issues Loom Large
Fatal Inflexibility: One Plan To Fit All
The Price of Failure
Forward to the Present
Magic Bullets
Malaria, Man, and Mosquito: The Biologic Perspective


Smallpox: the Right Disease, the Right Time

Fading Scars
From Golden Needles to Vaccine
Moving toward Control
Thinking about Eradication
Commitment, Evolution, Success
Smallpox Zero
The Smallpox Dividend
An Incomplete Life: The Biologic Perspective


Polio: the Rise and Fall of a Disease

The Countdown
Biologic Realities
The Invisible Disease
The Clearing Picture
President Roosevelt's Other War
The Needs of the World
Brazil's Attack
Coming to America
Going Global
Measures of Success-or Failure
The End Game
Another Virus, Another Vaccine: The Biologic Perspective

The Future for Global Disease Eradication

Biologic Feasibility
Financial Resources
Political Will
Social Benefit
The Next Campaign

Epilogue:  Voices from the Eradication Campaigns

Christopher Plowe and Abdoulaye Djimde: Malaria Warriors
Donald Ainslie Henderson: Politics and Public Health
William Foege: Legacy of the Smallpox Campaign
Sharon Bloom: When Politics Are Local
Phillip Spradling: from Primary Care to the Mountains of Nepal
Kathy Kohler: Fulfilling a Dream
Alice Pope: a Passion for People
Duane Kilgus: from Desk to Desert
Virginia Swezy: a Champion in the Final Leg of the Race
Steve Stewart: Roads and Rivers
Fabio Leviano: Opening Pandora's Box
Donald Hopkins: the Blowing of a Certain Trumpet
Walter Dowdle: the Leader People Barely Know Exists
Steve Cochi: Turning Dreams into Reality
The World Health Organization