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Elimination
Reduction to zero of the incidence of a disease in a defined geographical area.
Continued interventions required to prevent re-introduction (e.g. polio in the Americas, COVID in New Zealand).
Elimination as a public health problem (e.g. trachoma, lymphatic filariasis, leprosy)
Eradication
Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent.
Intervention measures no longer needed (e.g. smallpox)
Biological
Effective intervention
Surveillance: practical
No animal reservoir
Social and political
The disease must be widely recognised to be of public health importance
Elimination must be perceived as a worthy goal by all levels of society
A technically feasible intervention must have been field-tested and found effective
Political commitment must be obtained at the highest levels (WHA resolution)
Advocacy plan must have been prepared
Issues with original leprosy elimination campaign
Dowdle WR. The principles of disease elimination and eradication. Bull. WHO 1998; 76 (suppl 2): 22