Log out
My profile and settings
My bookmarks
Comment history
Please complete your account verification. Resend verification email.
today
This verification token has expired.
today
Your email address has been verified. Update my profile.
today
Your account has been deactivated. Sign in to re-activate your account.
today
View all newsletters in the newsletter archive
today
You are now unsubscribed from receiving emails.
today
Sorry, we were unable to unsubscribe you at this time.
today
0
0
Back to profile
Comment Items
You have not left any comments yet.
title
you replied to a comment:
name
description
Saved Posts
You haven’t bookmarked any posts yet.

With a pathway to follow, students are less likely to feel lost and more likely to find their way—through school and to a fulfilling career.

Read more
Become a Gates Notes Insider
Sign up
Log out
Personal Information
Title
Mr
Mrs
Ms
Miss
Mx
Dr
Cancel
Save
This email is already registered
Cancel
Save
Please verify email address. Click verification link sent to this email address or resend verification email.
Cancel
Save
Email and Notification Settings
Send me updates from Bill Gates
You must provide an email
On
Off
Send me Gates Notes survey emails
On
Off
Send me the weekly Top of Mind newsletter
On
Off
Email me comment notifications
On
Off
On-screen comment notifications
On
Off
Interests
Select interests to personalize your profile and experience on Gates Notes.
Saving Lives
Energy Innovation
Improving Education
Alzheimer's
Philanthropy
Book Reviews
About Bill Gates
Account Deactivation
Click the link below to begin the account deactivation process.
If you would like to permanently delete your Gates Notes account and remove it’s content, please send us a request here.

Curing the World

Lessons from eradication

Nancy Leys Stepan has written a useful history of efforts to eliminate diseases.

|
0

I don’t remember the first time I heard of smallpox, but when I was a kid in Seattle in the 1960s it wasn’t exactly top of mind for my friends and me. I’m sure I heard about it when the World Health Organization announced in 1980 that smallpox had been eradicated, but I still didn’t pay much attention. After all, smallpox had been eradicated in the United States for almost a century; it’s hard to get too worked up about a disease that nobody you know has ever gotten. It wasn’t until later, when our foundation joined global eradication efforts, that I really started thinking about what it takes to wipe a disease from the face of the earth. Most people think it’s incredibly difficult. It turns out, it’s much harder than that.

That’s why I enjoyed Nancy Leys Stepan’s book Eradication: Ridding the World of Diseases Forever?. It gives you a good sense of how involved the effort to eradicate a disease can get , how many different kinds of approaches have been tried without success, and how much we’ve learned from our failures.

To illustrate the history of eradication, she focuses on the career of Fred Soper, who led efforts to eradicate yellow fever, typhus, and malaria, first at the Rockefeller Foundation and then, from 1947 to 1959, as director of the Pan-American Health Organization.

I’m a little more positive on Soper than Stepan is, but the view she gives of him is very balanced. He got a lot done, but he did it by being extremely demanding, both in his eradication methods and in his dealings with people, and that made him both very effective in some ways and very difficult to deal with. He reportedly tried to strangle somebody who disagreed with him in a meeting. Despite his faults, though, without Soper, I don’t know that we would have eradicated smallpox or that we would be on the verge of eradicating polio.

Soper’s biggest mistake—and on this I agree with Stepan—was believing that scientists had already learned everything there was to learn about mosquitoes and malaria. Because of that he spent a lot of time and money—and made life harder for a lot of people—trying to eradicate a disease that actually was not understood well enough. Scientists didn’t have enough of the right data. Soper didn’t have a deep enough understanding of human behavior and international politics. And most of all, he didn’t doubt himself enough. I think we’re approaching all these issues in better ways today, and I remain optimistic about the world’s strategy to get rid of malaria for good.

I feel similarly optimistic about the effort to eradicate polio. Although it has taken longer and cost more than we thought it would, there are now only two countries that have never been polio-free—Afghanistan and Pakistan—and we're on the verge of eradicating it entirely. Once that happens, we’ll be able to use the infrastructures we’ve set up for taking on other diseases.

I do disagree with some of Stepan’s arguments. For example she faults eradication programs for not strengthening health infrastructures—she writes that they can come “at the expense of a broader approach to ill health.” In theory, they can—but more and more, they don’t. The systems being put in place to deal with polio are actually strengthening health systems more broadly. Part of the reason Nigeria was able to contain Ebola during the recent outbreak was that polio workers there were able to step in to help with the response. Without them, the country's 180 million citizens would have been at far greater risk; in fact, in countries without the polio-eradication infrastructure, the outbreak was much worse.

Finally, a word of warning: Eradication is written in a very academic style, and it may be a challenge for non-experts to get to Stepan’s valuable arguments. It’s worth the effort, though, because you come away from it with a clearer sense of what the world has learned about getting rid of diseases and how we can use that to guide the effort to save even more lives.

Discussion
Thank you for being part of the Gates Notes Insider community.
Not seeing your comment? You can read our policy on moderating comments here and learn about our Gates Notes badges here.
Badge
📌
Pinned by
Gates Notes
Badge
ʼʼ
0 responses
Sort by
all
all
most
top
old
Comments loading...
CTW
Thanks for visiting the Gates Notes. We'd like your feedback.
Become a Gates Notes Insider
Join the Gates Notes community to access exclusive content, comment on stories, participate in giveaways, and more.
SIGN UP
Already have an account?
Log in here
Logout:


Become a Gates Notes Insider
Become a Gates Notes Insider
Join the Gates Notes community to get regular updates from Bill on key topics like global health and climate change, to access exclusive content, comment on stories, participate in giveaways, and more.
Already joined? Log in
Please send me updates from Breakthrough Energy on efforts to combat climate change.
On
Off
LOG IN
SIGN UP
Title
Mr
Mrs
Ms
Miss
Mx
Dr
This email is already registered. Enter a new email, try signing in or retrieve your password
Why are we collecting this information? Gates Notes may send a welcome note or other exclusive Insider mail from time to time. Additionally, some campaigns and content may only be available to users in certain areas. Gates Notes will never share and distribute your information with external parties.
Bill may send you a welcome note or other exclusive Insider mail from time to time. We will never share your information.
Sign up
We will never share or spam your email address. For more information see our Sign Up FAQ. By clicking "Sign Up" you agree to the Gates Notes Terms of Use / Privacy Policy.
Street address
City
postal_town
State Zip code
administrative_area_level_2
Country
Data
Gates Notes Insider Sign Up FAQ

Q. How do I create a Gates Notes account?

A. There are three ways you can create a Gates Notes account:

  • Sign up with Facebook. We’ll never post to your Facebook account without your permission.
  • Sign up with Twitter. We’ll never post to your Twitter account without your permission.
  • Sign up with your email. Enter your email address during sign up. We’ll email you a link for verification.

Q. Will you ever post to my Facebook or Twitter accounts without my permission?

A. No, never.

Q. How do I sign up to receive email communications from my Gates Notes account?

A. In Account Settings, click the toggle switch next to “Send me updates from Bill Gates.”

Q. How will you use the Interests I select in Account Settings?

A. We will use them to choose the Suggested Reads that appear on your profile page.

BACK
Forgot your password?
Enter the email you used to sign up and a reset password link will be sent to you.
This email is already registered. Enter a new email, try signing in or retrieve your password
Reset Password
Reset your password.
Set New Password
Your password has been reset. Please continue to the log in page.
Log in
Get emails from Bill Gates
Send me updates from Bill Gates
You must provide an email
On
Off
Email me comment notifications
On
Off
On-screen comment notifications
On
Off
This email is already registered
Finish
We will never share or spam your email address. For more information see our Sign up FAQ. By clicking "Continue" you agree to the Gates Notes Terms of Use / Privacy Policy.
You're in!
You're in!
Please check your email and click the link provided to verify your account.
Didn't get an email from us? Resend verification
Upload a profile picture
Choose image to upload
Uploading...
Uh Oh!
The image you are trying to upload is either too big or is an unacceptable format. Please upload a .jpg or .png image that is under 25MB.
Ok
Title
Mr
Mrs
Ms
Miss
Mx
Dr
Cancel
Save
This email is already registered
Cancel
Save
Please verify email address. Click verification link sent to this email address or resend verification email.
Email and notification settings
Send me updates from Bill Gates
You must provide an email
On
Off
Email me comment notifications
On
Off
On-screen comment notifications
On
Off
Select your interests
Saving Lives
Energy Innovation
Improving Education
Alzheimer's
Philanthropy
Book Reviews
About Bill Gates
Finish
Confirm Account Deactivation
Are you sure you want to deactivate your account?
Deactivating your account will unsubscribe you from Gates Notes emails, and will remove your profile and account information from public view on the Gates Notes. Please allow for 24 hours for the deactivation to fully process. You can sign back in at any time to reactivate your account and restore its content.
Deactivate My Acccount
Go Back
Your Gates Notes account has been deactivated.
Come back anytime.
Welcome back
In order to unsubscribe you will need to sign-in to your Gates Notes Insider account
Once signed in just go to your Account Settings page and set your subscription options as desired.
Sign In
Request account deletion
We’re sorry to see you go. Your request may take a few days to process; we want to double check things before hitting the big red button. Requesting an account deletion will permanently remove all of your profile content. If you’ve changed your mind about deleting your account, you can always hit cancel and deactivate instead.
Submit
Cancel
Thank You! Your request has been sent
Page https://www.gatesnotes.com:443/ secs = 0.031205