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CSU 74/2011: CONTROL, ELIMINATION, ERADICATION

Wednesday, 2nd of March 2011

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.