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CSU 27/2008: CONTROL, ELIMINATION, ERADICATION
In this nice discussion, Molyneux and colleagues call for consistent usage
of these related but separate terms.
Control refers to the reduction of a public health problem to a minor
scale. We can control mumps or pertussis without attempting elimination or
eradication. Now that onchocerciasis is being cleared from the western
hemisphere, the term "regional elimination" is coming into play for river
blindness.
Elimination refers, in current parlance, most often to maternal and
neonatal tetanus which, because they stay in the environment, can be
reduced to an incidence under 1 per 1000 livebirths, which is defined as
elimination.
Eradication refers to smallpox and (soon) polio, in which all transmission
chains are broken, incidence falls globally to zero, and the etiologic
agent is confined to WHO approved laboratories.
Good reading.
BD
Trends Parasitol. 2004 Aug;20(8):347-51.
Disease eradication, elimination and control: the need for accurate and
consistent usage.
Molyneux DH, Hopkins DR, Zagaria N.
Lymphatic Filariasis Support Centre, Liverpool School of Tropical Medicine,
Pembroke Place, Liverpool L3 5QA, UK. fahy@liv.ac.uk
This article seeks to clarify the terminology associated with disease
control, elimination and eradication programmes. There are several global
activities under way, which are initiated and guided by resolutions of the
World Health Assembly. Scrutiny of the feasibility of achieving eradication
goals by bodies such as the International Task Force for Disease
Eradication has identified diseases that could be eradicated. The criteria for this
attribution as eradicable, the definitions guiding policy, and examples of
programmes and strategies are provided here. This article pleads for
scientific, health policy and editorial communities to be more consistent
in the use of the terms control, elimination and eradication, and to adhere to
published definitions.