Abstract
The past two centuries have seen enormous achievements in control of infectious diseases, previously the leading cause of death, in large measure due to sanitation and food safety, vaccines, antibiotics and improved nutrition. This has led people to put their faith in the notion that medical science would succeed in overcoming the remaining obstacles. Vaccination has eradicated smallpox, nearly eradicated poliomyelitis and greatly reduced many other highly dangerous infections such as diphtheria, tetanus and measles. New diseases such as HIV and new forms of influenza have taken both professional and popular opinion by surprise and have renewed the challenges before the world public health community. Emergence of antibiotic-resistant strains of common organisms due to overuse of antibiotics and lack of vaccines for many dangerous microorganisms poses problems to humanity. This stresses the need for new vaccines, effective antibiotics and strengthened environmental control measures. New knowledge of the microbiological origins of cancers such as that of the cervix, stomach and liver have strengthened primary prevention and brought hope that new cures will be found for other chronic diseases of infectious origin. Tragically long delays in adopting “new” and cost effective vaccines cause hundreds of thousands of preventable deaths each year in developing and mid-level developed countries. Gains are being made in control of many tropical diseases, but malaria, tuberculosis and other infectious diseases remain enormous global problems. Research and acquisition of new knowledge, risk communication, application of currently available means and fair distribution will be great challenges to public health in the coming decades.
Highlights
Public health has had enormous triumphs in the field of infectious disease control,[1] as illustrated by the eradication of smallpox, the near-eradication of poliomyelitis and the eye-opening discovery that stomach ulcer is caused by the Helicobacter pylori organism.[2]
it seems reasonable to anticipate that within some measurable time... all the major infections will have disappeared.”[5]. Five years later, the U.S Surgeon General noted that “it might be possible with interventions such as antimicrobials and vaccines to close the book on infectious diseases and shift public health resources to chronic diseases.”[6,7]
Only smallpox was targeted for eradication, and after this was successfully achieved, other infectious diseases such as poliomyelitis and measles, proving hard to eradicate, were targeted as well as public health problems requiring control and elimination, such as onchocerciasis, leprosy, rubella syndrome and many others
Summary
Public health has had enormous triumphs in the field of infectious disease control,[1] as illustrated by the eradication of smallpox, the near-eradication of poliomyelitis and the eye-opening discovery that stomach ulcer is caused by the Helicobacter pylori organism (see foreword).[2]. Total eradication of a disease requires a specific set of conditions: the human being as the unique host, an antigenetically stable pathogen and an effective vaccine with long-lasting immunity for acute non-chronic diseases which lack animal hosts.[38] Initially, only smallpox was targeted for eradication, and after this was successfully achieved, other infectious diseases such as poliomyelitis and measles, proving hard to eradicate, were targeted as well as public health problems requiring control and elimination, such as onchocerciasis, leprosy, rubella syndrome and many others.
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