Eradication: Ridding the World of Diseases Forever?

by Nancy Leys Stepan

The dream of a world completely free of disease may seem utopian. Yet eradication, used in its modern sense to mean the reduction of a disease to zero by means of purposeful public health interventions, has been pursued repeatedly. Campaigns against yellow fever, malaria, smallpox, and polio are among the largest, most costly programmes ever undertaken in international public health. Only one so far has been successful - against smallpox in 1980, though eradication campaigns against polio and Guinea Worm Disease are ongoing. Are such programmes, then, worthwhile? Does setting an absolute goal help focus efforts in the health field; or does such a project lead almost inevitably to disappointment? This book surveys the history of eradication, covering all the major eradication campaigns and bringing the story up to date. It bases its narrative on the life and times of an arch-eradicationist, Dr Fred Lowe Soper (1893-1977). Known for his forceful style in public health, and his single-minded dedication to eradication, Soper was at the centre of all the campaigns and controversies surrounding eradication in his lifetime. Eradication is, of course, only one approach to improving people's health. Debates between proponents of Primary Health Care approaches to ill-health versus the eradicationists' approach have often been intense. Nancy Leys Stepan, well-known for her authoritative books in the history of medicine, suggests that today the two approaches may be complementary, rather than incompatible. Eradication is aimed at the general reader interested in the urgent problems of health and disease around the world, as well as specialists in the field.

Genres: Science, Nonfiction, Health, Medicine, Biology, History, Health Care

309 pages, Hardcover

First published January 1, 2011

Reviews

[Ricardo Moreno Mauro · Rating 4 out of 5]

Este libro cuenta la historia del concepto de eradicación. Vemos como tuvo sus origenes en la post guerra y como algunas enfermedades se convirtieron en símbolos de esta "batalla" contra la naturaleza Malaria, polio, tuberculosis, etc. Mezclado en un ambiente donde el conocimiento científico emerge para fomentar la medicina, y potenciado por la guerra fría vemos como este concepto se apropia del mundo occidental y es usado como un arma política.

Excelente desde un punto de vista histórico y muy bien tratados los concptos de biomedicina.

[Maxine · Rating 5 out of 5]

The last case of Small Pox worldwide was reported in Somalia in 1977. In 1980, the World Health Organization (WHO) formally declared the successful eradication of this disease. Thus, it became the first and, to date, the only disease to be successfully eradicated as defined by Dr Fred Soper (1893-1977) ie. the reduction to zero of a disease through deliberate intervention.

It is not, however, the only, or even the first or most costly, attempt at eradication. Malaria, Yellow Fever, Polio and Guinea Worm have all been targeted at various times and with varying degrees of success.This book outlines the history of eradication, the different methods used and the different countries they were used in and why, with the exception of Small Pox, they have, so far, failed. The author discusses the socio-economic, biological, and political aspects of each attempt. She also discusses whether eradication is an achievable or even desirable goal and looks at other, less absolute, approaches to disease control.

This book is a fascinating look at the history of disease eradication. It is well-written and well-researched. It is aimed at the general reader as well as historians and those in the field of medicine. As one of those general readers, I can't say that this is an easy read - there are no 'human interest' stories interspersed among the facts as in other books of this type - but this is definitely a book worth reading on one of the most important issues facing us today - the state of the world's health.

[Ariel · Rating 4 out of 5]

You're going to learn a lot about mosquitoes.

[Simon Howard · Rating 4 out of 5]

Nancy Leys Stepan gives a comprehensive history of work to eradicate various infectious diseases, with a unifying thread of the work of Fred Lowe Soper.

There was a huge amount in here which was new to me, and it was thoroughly readable for a general audience. Stepan gives a great and sobering illustration of how many attempts at disease eradication have failed for essentially the same reasons. I also thought that she gave a balanced account of the dangers of eradication programmes, and in particular the diversion of resources from projects which might have a greater impact on the health of populations. That said, Stepan sometimes got a little bit stuck in the fine details of some of her examples

Essentially, Stepan made me think much more deeply than I have previously about attempts at disease eradication. Her thesis, as stated in the book, is that "eradication campaigns should be exceptional and rare" - and I was fully convinced by her arguments.

As a sort of public note to self - I'm doing some work around TB control in low incidence areas at the moment, and was struck by this paragraph on page 215 which is relevant:

"The phrase, 'the realm of the final inch' was appropriated (and modified) by Henderson from the Russian Alexandr Solzhenitzyn's novel, 'First Circle' (1968); Henderson used it to indicate the crucial moment that Soper had always singled out in his discussions, when a disease or a vector targeted for eradication has almost disappeared; at this point, the costs per case detected and eliminated go up, just as the visibility of the disease practically disappears. Almost invariably, the urgency of the pursuit vanishes too, vigilance diminishes, controls peter out, and the disease on which so much time and effort has been expended eventually returns."

[Cheryl · Rating 4 out of 5]

A bit dry at times but a fascinating look at the different diseases the world has been trying to get rid of. I thought polio had been eradicated but only small pox is and children no longer receive a vaccine for it. That was a terrible disease but it is scary to think that there are 2 labs, one in Moscow and one in Atlanta Georgia that still have live small pox virus and a discussion is still going on about whether to destroy them or not. The book was written in 2011 but near the beginning, there was a paragraph about the people in the early 1900s that could easily describe what we are going through right now and proves that we are all just human beings trying to do the best we can.
"Education, full citizenship, participation, and political equality are the historical routes to achieving the cooperation between individuals and the authorities that is necessary to make public health work; public health fiascos have many causes, but non-compliance tends to occur when the public do not in fact share the values of the authorities, or have lost confidence in their expertise."

[Mark · Rating 3 out of 5]

Pretty rough read - very academic, note-heavy, and dry. It felt like the topic either warranted a much longer or much shorter treatment and ended up in the middle. As it was, it was difficult finding the key points in a sea of history and data. But the essence wasn't completely lost - eradication as a policy can be alluring, often for good reasons, but it tends to be exceedingly difficult to achieve and might be at odds with other approaches and other public health goals. Readability 4. Rating 5.

[John Howland · Rating 4 out of 5]

An interesting look into global public heath's history with eradication of diseases. It is a technical read that can be a bit dry but is well researched and follows in a clear and logical manner.

[David López · Rating 4 out of 5]

It is not common to read such a detailed chronicle about such specialized field as medicine, particularly epidemiology.
The write is monotonous but the facts portrayed are well documented and are portrayed from a broad perspective that takes into account historical, political and economical factors. In this book there are no easy answers and probably no final conclusions, but there is a lot to learn. My main learning is that disease control/eradication is a complicated matter that has been tackled successfully in a small number of occasions. However, this occasions together with the failures can give us insightful knowledge for an approach to public health that is inclusive, realistic and effective.

[Andy · Rating 3 out of 5]

The author chose to frame the book around the life and ideas of Dr. Fred Soper. This leads her to spend many pages on trivia that I found boring and irrelevant. This is a shame because disease reduction is an important topic and she has many good insights. I think though that I would recommend the books below for understanding how to fight "tropical" diseases or to get the story of the successful eradication experience.

[Filipa · Rating 4 out of 5]

An interesting take, not only on the complicated history of eradication attempts but also on current challenges for eradication and other public health interventions.

[Raven · Rating 4 out of 5]

reads more like a mystery than nonfiction - and that's a good thing here

[Beth · Rating 4 out of 5]

Fascinating subject matter but could have used another round of editing. Very uneven organization and level of detail.