From smallpox eradication to the future of global health: Innovations, application and lessons for future eradication and control initiatives

Abstract

Technological advancements, including landmark innovations in vaccinology through molecular virology, and significant transformation and changes in the society have taken place since the eradication of smallpox thirty years ago. The success with eradicating smallpox gave confidence for initiating the eradication of other diseases, such as malaria and polio. However, these efforts have not been as effective, as recorded for small pox, for a variety of reasons. There is now a debate within the global health community as to whether eradication campaigns should be abandoned in favor of less costly and perhaps more effective primary health and containment or control programmes. Significant changes that have taken place in the last thirty years, since the eradication of smallpox include, among others, (i) post-colonial political changes, with varying commitment to disease eradication initiatives, especially in the parts of the world most burdened by infectious and vaccine preventable diseases, (ii) innovations leading to the development of new and highly effective vaccines, targeted to specific diseases, (iii) the transformation brought about by improvement in education and the new global access to information (cell phones, internet, etc.), leading to an unlimited access to different types of information, subject to either positive or negative use. At the onset of eradication of smallpox, global health was confined in its operation. Today, global health is at the intersection of medical and social science disciplines-including demography, economics, epidemiology, political economy and sociology. Therefore, in considering the issue of disease eradication, medical and social perspectives must be brought into play, if future eradication programmes must succeed. The paper discusses the roles of these disciplines in disease control and eradication, especially as it affects sub Saharan Africa, the melting pot and verdant pasture of infectious diseases.