Nancy Leys Stepan


On her book Eradication: Ridding the World of Diseases Forever?

Cover Interview of November 15, 2011

In a nutshell

Eradication tells the story of modern efforts to rid the world of diseases completely.

I use the term “eradication” in the book in its modern, precise, public health sense. Eradication does not mean disease control or reduction. It means the reduction of the incidence of a specific disease to zero, by deliberate human interventions.

Disease eradication therefore stands for an absolute, for a vision of the world free of some of the major scourges of human beings. It is highly idealistic goal, utopian even. As such, it seemed to me worth asking why such a utopian ideal was taken up in health circles, and with what effects?

I knew smallpox was the one disease that had been eradicated: its eradication was declared officially in 1980 by World Health Organization (WHO).

And since it was the only one, I thought it might be a one-off and rather curious exception to usual international health efforts.

But a little investigation showed this was far from the case.

Yes, smallpox is the only disease we have eradicated completely so far—but eradication campaigns have been conducted against many other diseases, such as yaws, hookworm disease, yellow fever and malaria.  Polio and Guinea Worm disease are currently the focus of two major eradication campaigns, and recently the Bill and Melinda Gates Foundation has vowed to try and eradicate malaria—once again.

These health campaigns have been amongst the most costly and complex efforts ever undertaken in international health. They have involved the resources of most of their day’s major international health organizations, from the Rockefeller Foundation in the pre-World War II decades, to WHO and others after the war.

It seemed then, that telling the story of eradication, from its early twentieth century origins to the present, would introduce me, and the reader, to a huge slice of international health history.

I was lucky because I came to the story via a particular person, Fred Lowe Soper, whose work on yellow fever I already knew about.

Soper, it turned out, was the arch-eradicationist of his day (and his day spanned almost the entire twentieth century). He was the person who popularized the idea of disease eradication as an absolute; he participated in nearly all the major eradication campaigns of the century.

The book is not a biography of Soper; but his life, his discussions, his friendships and his actions provide a chronological framework for a history of an idea in public health that has been highly influential yet also curiously neglected in history books.

Soper has the virtue, as a character, of being very sure of himself, a person of great tenacity and will-power, with all the strengths and weaknesses of a true believer.

He spent years working abroad in public health, running, for instance, a massive yellow fever eradication program, convinced of the rightness of his goal (though we know now that yellow fever cannot, for biological reasons, be eradicated).

Soper left a huge number of documents. He had many critics. Indeed, eradication continues to be controversial.  For all these reasons, he was the perfect person through which to evaluate the history of eradication.