|
Since smallpox eradication, the science of eradication has changed and with it, our definitions of what diseases are possible to eradicate. For example, many diseases, such as polio, measles, onchocerciasis, dracunculiasis, lymphatic filariasis, leprosy, and Chagas diseases, once thought not to be eradicable, are now targeted for elimination and subsequent eradication.
The legacy of smallpox eradication has removed the worldwide suffering caused by this disease, has resulted in yearly savings of substantial financial resources that are no longer needed for its treatment and prevention, and has helped build consensus and confidence to expand eradication programs to other diseases. However, eradication must not beget complacency.
As has been learned from past control or eradication attempts with a variety of viral diseases, from yellow fever to influenza, accidental or intentional reintroduction is a real threat-one that could strike anywhere and for which we need to be fully prepared. This is especially true as immunity wanes in the post-eradication era and the population grows increasingly more susceptible to infection.
The criteria for assessing eradicability of polio, measles, and other viral infections have been debated extensively. What is often specifically not addressed are the relative desirability and feasibility, and the time required, for stopping immunizations. With the elimination and eradication of several viral diseases on the horizon, issues surrounding the cessation of immunization activities become exceedingly important. Resolution of the issues affecting if or when and how immunization and other prevention activities can be stopped in conjunction with disease eradication are paramount to domestic and international public health agencies, pharmaceutical and vaccine manufacturers, and security analysts.
In an effort to better understand the dynamics of disease eradication and post-immunization policies, the Institute of Medicine (IOM)'s Forum on Emerging Infections hosted a two-day workshop (February 1-2, 2001) on The Consequences of Viral Disease Eradication. The workshop summary report explores the principles underlying the biological challenges, medical interventions, the continuing research agenda, and operational considerations for post-immunization strategies for vaccine-preventable viral diseases, and highlights important efforts that may facilitate wise decision making.
You can read Considerations for Viral Disease Eradication: Lessons Learned and Future Strategies on the NAP website (http://www.nap.edu/catalog/10424.html).
|