Disease considered as candidates for global eradication by the International Task Force for Disease Eradication1 Current annual toll Disease worldwide Chief obstacles to eradication Conclusion Diseases targeted for eradication Dracunculiasis <10,000 persons infected; Sporadic insecurity Eradicable (Guinea worm disease) few deaths WHA 44.5 (1991) Lymphatic filariasis 120 million cases Weakness of primary health care systems Potentially eradicable in Africa; increased national/international WHA 50.29 (1997) commitment needed Measles 780,000 deaths, mostly Lack of suitably effective vaccine for Potentially eradicable among children young infants; cost; public misconception of seriousness Mumps Unknown Lack of data on impact in developing Potentially eradicable countries; difficult diagnosis Poliomyelitis 2,000 cases of paralytic Insecurity; low vaccine coverage; Eradicable disease; 200 deaths increased national commitment needed WHA 41.28 (1988) Rubella Unknown Lack of data on impact in developing Potentially eradicable countries; difficult diagnosis Taeniasis/cysticercosis 50 million cases; 50,000 Demonstration of elimination on national Potentially eradicable (pork tapeworm) deaths scale Diseases/conditions of which some aspects could be eliminated American trypanosomiasis 10—12 million infected Difficult diagnosis, treatment; animal Not eradicable; can stop (Chagas’ disease) reservoirs vector-borne transmission to humans in some areas Hepatitis B 250,000 deaths Carrier state, infections in utero not Not now eradicable, but preventable; need routine infant could eliminate vaccination transmission over several decades Iodine deficiency disorders Unknown Inadequate surveillance, lack of Could eliminate iodine environmental sources of iodine deficiency disorders Malaria >300 million cases; >1 National and international commitment, Not now eradicable; million deaths weak primary health care systems; drug elimination possible in and insecticide resistance; non-specific Hispaniola diagnoses Neonatal tetanus 560,000 deaths Inexhaustible environmental reservoir Not now eradicable, but could prevent transmission Onchocerciasis 37—40 million cases; Lack of macrofilaricide and test for living Could eliminate (river blindness) 340,000 blind adult worms associated blindness in Africa; and probably transmission in the Americas Rabies 52,000 deaths No effective way to deliver vaccine to Could eliminate urban wild animals that carry the disease rabies Trachoma 150 million cases; Link to poverty; inadequate rapid Could eliminate 6 million blind assessment methodology and diagnostic associated blindness test for ocular infection WHA 51.11 (1998) 1 (Updated April 2008) CDC. Recommendations of the International Task Force for Disease Eradication. Morbidity and Mortality Weekly Report 1993; 42(RR-16):8. This report and summaries from ITFDE (II) meetings can be found at www.cartercenter.org. Yaws and other endemic Unknown Lack of political will, inadequate Could eliminate treponematoses funding, weaknesses in primary health transmission nationwide, care systems as shown by India* Diseases that are not eradicable now Ascariasis (roundworm) 1 billion infected; 20,000 Eggs viable in soil for years; laborious Not now eradicable deaths diagnosis; widespread Cholera Unknown Environmental reservoirs; strain Not now eradicable differences Diphtheria Unknown Difficult diagnosis; multiple-dose Not now eradicable vaccine Hookworm disease 740 million cases; 10,000 Increased national and international Not now eradicable deaths commitment; monitoring impact of interventions Leprosy (Hansen’s disease) 225,000 cases Need for improved diagnostic tests and Not now eradicable chemotherapy; social stigma; potential reservoir in armadillos Meningococcal meningitis 614,000 cases; 180,000 Lack of serogroup A conjugate vaccine; Not now eradicable deaths cost Pertussis 40 million cases; 400,000 High infectiousness; early infections; Not now eradicable (whooping cough) deaths multiple-dose vaccine Rotaviral enteritis 80 million cases; 870,000 Inadequate vaccine Not now eradicable deaths Schistosomiasis 200 million infected Reservoir hosts; increased snail- Not now eradicable (bilharziasis) breeding sites; need simple diagnostic test for intestinal disease Tuberculosis 8–10 million new cases; 2– Need for improved diagnostic tests, Not now eradicable 3 million deaths chemotherapy and vaccine; wider application of current therapy Visceral leishmaniasis 500,000 cases Inadequate surveillance, drug supply and Not now eradicable knowledge of vector breeding sites; weak primary health care systems Yellow fever >10,000 deaths Sylvatic reservoir; heat-labile vaccine Not now eradicable Diseases that are not eradicable African trypanosomiasis 300,000—600,000 infected Reservoir hosts; difficult treatment and Not eradicable diagnosis Amebiasis 500 million cases; Asymptomatic infections; difficult Not eradicable 40,000—110,000 deaths diagnosis, treatment Bartonellosis Unknown Asymptomatic infections; difficult Not eradicable diagnosis, treatment Buruli ulcer Unknown Inadequate surveillance, early detection Not eradicable and treatment; need field diagnostic test and orally administered treatment Clonorchiasis 20 million cases in China Animal reservoir; asymptomatic Not eradicable alone infections; carrier state Enterobiasis Unknown Widespread; mild disease Not eradicable Varicella zoster 3 million cases in USA Latency of virus; inadequate vaccine Not eradicable alone *Because persons may be infected for decades and the organisms cannot be distinguished from those that cause venereal syphilis, elimination of transmission–not eradication–is the goal. .