Definitions

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)

Requirements for elimination of eradication

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

References

• Dowdle WR. The principles of disease elimination and eradication. Bull. WHO 1998; 76 (suppl 2): 22