Nancy Leys Stepan


On the continued appeal of disease eradication

Cover Interview of January 01, 2012

On the other hand, I use the example of the current campaign to eradicate Guinea Worm Disease (GWD) to argue that, today, under the right circumstances, eradication and primary health care need not be in conflict, as they were in the past.

GWD was an obscure disease to most people in the west when it was first proposed for eradication by The Carter Center in 1981, though its worldwide incidence was believed to be in the millions.

Since there was no drug or vaccine for GWD, preventing people from drinking water contaminated with minute arthropods that carry the Guinea worm larvae was the only way to interrupt transmission. In principle, complete interruption, and therefore eradication, is possible through these methods.

As a locally-organized, bottom-up, preventive program, GWD eradication takes on the features of a basic health program. It has already reduced incidence to very small numbers.

If successful, GWD would suggest that eradication and primary care can form mutually reinforcing policies to improve health, especially the health of the poorest and most disease-burdened populations of the world.