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The Carter Center International Task Force for Disease Eradication

The International Task Force for Disease Eradication. The Carter Center

Inspired by the successful eradication of smallpox in 1977, the International Task Force for Disease Eradication formed at The Carter Center in 1988 to evaluate disease control and prevention and the potential for eradicating other infectious diseases. Composed of scientists and notable international health organizations from around the world, the task force has identified seven diseases that could be eradicated.

Between 1988 and 1992 the task force concluded that six diseases – dracunculiasis, poliomyelitis, mumps, rubella, lymphatic filariasis, and cysticercosis – could be eradicated. Measles was added to this list with the current task force in 2002. Disease considered as candidates for global eradication by the ITFDE PDF File

The current task force reconvened in June 2001 to work further on international health with support from the Bill & Melinda Gates Foundation. The main goals of the revived task force are to review progress in the field of disease eradication, review the status of selected diseases for control or eradication, and make recommendations regarding opportunities for eradication or better control of certain diseases.

In 2008, The Carter Center supported two task force recommendations to encourage cooperation between the Dominican Republic and Haiti to eliminate lymphatic filariasis and malaria from Hispaniola, and to convene the first program review for Buruli ulcer programs in Benin, Cote d'Ivoire, Ghana, and Togo. (Read the report from the Oct. 29, 2008 meeting of the ITFDE.)

Carter Center health programs address two of the diseases currently identified by the ITFDE for eradication (dracunculiasis and lymphatic filariasis) and three diseases identified for better control (onchocerciasis or river blindness, trachoma, and schistosomiasis).

Program definitions for disease eradication, elimination, and control

International Task Force for Disease Eradication (I) 1989-1992 1

Eradication: Reduction of the worldwide incidence of a disease to zero as a result of deliberate efforts, obviating the necessity for further control measures. True eradication usually entails eliminating the microorganism itself or removing it completely from nature.

Elimination: Refers to cessation of transmission of a disease in a single country, continent, or other limited geographic area, rather than global eradication (e.g., polio in the Americas). It is also theoretically possible to "eliminate" a disease in humans while the microbe remains at large (e.g., neonatal tetanus). Although a disease itself may remain, a particularly undesirable clinical manifestation of it may be prevented entirely (e.g., blindness from trachoma) or new transmission interrupted (e.g., infectious yaws). Control of a disease or its manifestations to a level that it is no longer considered "a public health problem," is an arbitrarily defined qualitative (e.g., onchocerciasis in West Africa) or quantitative (e.g., leprosy incidence below one case per 10,000 population) level of disease control.

Control: Reduced incidence or prevalence of a disease or condition; control measures are still required.

Berlin (Dahlem) Conference 1997, Atlanta Conference 1998 2

Extinction: The specific infectious agent no longer exists in nature or the laboratory.

Eradication: Permanent reduction to zero of the worldwide incidence of infection caused by a specific agent as a result of deliberate efforts; intervention measures are no longer needed.

Elimination of Infection: Reduction to zero of the incidence of infection caused by a specific agent in a defined geographic area as a result of deliberate efforts; continued measures to prevent reestablishment of transmission are required.

Elimination of Disease: Reduction to zero of the incidence of a specified disease in a defined geographic area as a result of deliberate efforts; continued intervention measures are required.

Control: Reduction of disease incidence, prevalence, morbidity, or mortality to a locally acceptable level as a result of deliberate efforts; continued intervention measures are required to maintain the reduction.

 

1 1993. Recommendations and Reports: Recommendations of the International Task Force for Disease Eradication. Morbidity and Mortality Weekly Report, 42:RR-16.

2 Dowdle, W.R. and Hopkins, D.R., eds., 1998. The Eradication of Infectious Diseases. New York: John Wiley & Sons.

Dowdle, W.R., 1998. The principles of disease elimination and eradication. Bulletin of the World Health Organization, 76(2): 38-41.

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Adapted with permission from the Carter Center website,www.cartercenter.org, February 2009.