The Medscape Awards in Infectious Diseases: Disease Most Likely to Be Eradicated From Earth

John G. Bartlett, MD


December 18, 2012

Editor's Note:
This is the third installment of the Medscape Awards in Infectious Diseases, a series that honors the greatest achievements in the field of infectious diseases. In this article, John G. Bartlett, MD, Professor of Medicine at Johns Hopkins University School of Medicine in Baltimore, Maryland, offers his choice for the infectious disease most likely to be the second eliminated from Earth.

Category: Disease Most Likely to Be Eradicated

The category of disease eradication becomes tenable because of the precedent established by smallpox. When medical audiences are queried about the greatest achievements in the past century in the field of infectious diseases, the 2 that always vie for top honor are the discovery of penicillin and the eradication of smallpox. The choice of smallpox eradication is understandable: That disease was common (>100,000 cases in the United States in 1921), morbidly disfiguring, and often fatal (300-500 million deaths worldwide).

Unlike penicillin, smallpox eradication, although officially announced in 1980, inexplicably never achieved Nobel Prize recognition. Nevertheless, smallpox eradication is one of the most amazing chapters in medical history. It was accomplished with a clear scientific agenda based on public health principles, a unique version of the world's first vaccine, plain grit, incredible stories of heroism, and a mere $100 million.

But smallpox is not the issue here. The question now is: What infectious disease will be number 2? Interest in this topic is substantial, because the question drives allocation of resources and has these benefits:

  • Disease eradication is the ultimate goal of public health;

  • It has great appeal to funders;

  • It is uniquely feasible, given the power of vaccines and antibiotics; and

  • It reduces human suffering in a measurable way.

The requirements for disease eradication have been reviewed at the Centers for Disease Control and Prevention (CDC), and the following criteria were established:[1]

  • Biological feasibility;

  • Adequate public health infrastructure;

  • Adequate funding support; and

  • Sustained political and societal will.

Candidates for the Disease Most Likely to Be Eradicated

The International Task Force for Disease Eradication based at The Carter Center, Atlanta, Georgia, has identified 7 infectious diseases as candidates for eradication.