The principles and feasibility of disease eradication.

Smallpox eradication framed disease eradication as a monumental public health achievement in global health equity. The principles of disease eradication are encapsulated in a constellation of four conditions: biologic feasibility, adequate public health infrastructure, sufficient funding, and sustained political/societal will. Where the constellation exists, national eradication occurs in the absence of a global initiative. Assessing the feasibility of global eradication requires determining the constellation gaps for nations of all regions and identifying the human and financial resources to fill the gaps. The economic and humanitarian benefits of eradication have strong appeal. Global polio and guinea worm efforts are underway. Regional eradication of measles and rubella has been achieved in the Americas and other diseases have been proposed. Global decisions on disease eradication should include careful consideration of opportunity costs and prioritization of limited global health resources, with the objective of providing the most appropriate, cost-beneficial, and equitable outcome of disease control.