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Eradication of a disease refers to the permanent reduction to zero cases of the global incidence of infection that are caused by a specific infectious agent due to the application of deliberate efforts (Bailey, Merritt & Tediosi, 2015) and therefore, in the case of eradication, intervention measures are not applicable at the process. A majority of the diseases can be eradicated with the presence of the right tools and resources that are directed to the elimination and the eventual eradication of the transmission agent as well as the eventual eradication of the condition. Among the diseases that are targeted for extermination are those that have a global concern affecting a vast geographical region and at the same time has a higher prevalence and incidence. Disease eradication is aimed at the maintenance of the health of the population as the conditions weaken the individuals rendering them weak and unable to work, and therefore the general productivity of a country is reduced. Having a healthy community that is free from diseases is one of the most significant challenges that are faced by the health sector, and therefore proper measures need to be put in place to control, eliminate and as well ensure the complete eradication of the conditions that affect a large population as well as a vast geographical region.
Various factors define whether a condition has attained the threshold for eradication as not all the conditions meet the defining criteria for eradication (Browne, Smith & Bourouiba, 2015). For one, for a condition be considered to be eradicated, an effective intervention should be available so that the transmission of the agent is interrupted denying the agent a chance to complete its life cycle. Cutting the transmission implies that the agent does not complete its life cycle and thus the successful transmission of the agent is not possible. Another condition that has to be fulfilled so that a disease can be termed to have qualified for eradication is the availability of practical diagnostic tools that can define the specificity and the sensitivity of the condition. The tools aid in identifying the people who have the condition of interest and those who have not. Another compliance that makes a disease qualify to be eradicated is that the humans play a significant role for the life cycle of the agent that leads to the condition of interest, implying that there is no other vertebrate reservoir and therefore does not amplify the environment.
Guinea worm is one of the conditions that have been targeted for eradication in accordance from the documentary Foul Water, Fiery Serpent. Guinea worm qualifies for the eradication since it affects a vast geographical area and in the same time affect a large population and therefore become a condition of interest. Apart from its significant contribution from the ill-health on a majority of individuals, Guinea worm qualifies as a condition for eradication. The first reason is that there are effective intervention programs to which interrupt the transmission of the agent to the intermediate host that include treatment of the water to kill the intermediate host, barring the infected individuals from contaminating the water sources and sieving the water to get rid of the intermediate host from being consumed by humans. Again, there is a clear-cut for the identification of the individuals infected with the worm and those who are not as those infected develop a swelling which eventually ruptures releasing the larvae cysts into the water. The development of the blisters, therefore, is a notification that the individual may be infected and consequently barred from wading into the water sources to prevent contamination of the water with the parasite aiding to the interruption of the transmission cycle. Besides, the humans are the primary host and play an important role to the life cycle of the agent, there are no other vertebrate host or reservoir, and therefore the manipulation of humans implies that Guinea worm qualifies for eradication. A prolonged interruption of the transmission for a longer duration in a large geographical area is another factor that qualifies a condition to be liable for eradication. An extended disruption completely denies the agent from completing its lifecycle and eventually to effective elimination and eradication.
During eradication, several primary factors contribute to the eradication of a condition. The elements need to pose no challenge in the process of extermination at any stage be it initiation phase or the evaluation phase. For the eradication process to be effective, some factors need to be in place such as the biological and technical feasibility, political and societal support and as well a consensus on the favorable costs and benefits (Aylward et al. 2000). In consideration of the case of the Guinea worm eradication, the society plays a vital role in the ensuring that the process of extermination has been made a success. Different cultures react differently, in South Sudan, the community was collaborative, and this secured a higher rate of success compared to Ghana. The people in South Sudan despite the area being too big were cooperative with the Carter Center adhering to the advice provided and as well reporting new cases of guinea worm infestation in their region. In Ghana, most of the members of the society were not collaborative and that a significant population believed that Guinea worm infestation was a curse and therefore did not understand what they were being told. The myths and misconception in the community concerning Guinea worm led to a prolonged duration before the management of the infestation.
Political support is another primary factor that contributes to the eradication of conditions (Newby et al. 2016), based on the evidence in the documentary, South Sudan was sometimes on crisis due to political instability leading to the country being torn into war, this made it impossible for the surveillance team to manage their work shifting their concentration to peacemaking. In Ghana, there existed political stability, but the government indulged into projects that were not immediately needed to control the infestation of the Guinea worm and therefore the installation of pumped was faced by significant challenges such as break down of the pipes. During this time most of the people returned to the old ways of obtaining water from the fields, contaminating it again leading to infestation.
The costs and benefits are also among the primary factors that contribute to the eradication of diseases (Schiller et al. 2010). The cost of eradication should be minimal while the benefits are expected to be at the maximum. The eradication of the guinea worm was only made difficult in times of war and traveling during the rainy season making the transportation of the necessary equipment’s to be hard. The essential tools for the eradication of Guinea worm were not costly, and straightforward measures such as creating awareness and restricting infected individuals from accessing or bathing at the water sources required very minimal amounts. The overall benefits of the eradication process were restoring the health of the individuals who were previously in pain and in the risk of losing their limbs to disability. Besides, the presence of the effective intervention measures contributes to the success of an eradication program in that the condition is wiped out with minimal time and resources. Another factor includes the availability of technical staff who are dedicated to the program providing support either as volunteers and professional staff. From the documentary, many local volunteers devoted their time in ensuring that the natives were a well-advised creating awareness on the cause, distributing and the control of the Guinea worm. The presence of willing and collaborative staff volunteers made it a success and therefore can be termed as a primary factor that is necessary for eradication.
Since the eradication of smallpox, the international community has not been able to completely eradicate most of the diseases or conditions that are targeted for eradication. From the efforts of the smallpox eradication program, various lessons can be learned that include the presence of the necessary vaccination technology at hand, the practicality of the eradication must be demonstrated in the field before the consideration of eradication. Besides, proper preparation needs to be done in advance to avoid failure and the loss of credibility for the public health professionals as well who are among the leading initiatives of the eradication program (Beigbeder, 2017). The inability to completely eradicate other conditions may, therefore, be due to the lack of enough preparedness or even the absence of the necessary technology at hand. It can also be speculated that inadequate pretesting and demonstration in the field may have failed in eradication.
ReferenceAylward, B., Hennessey, K. A., Zagaria, N., Olivé, J. M., & Cochi, S. (2000). When is a disease eradicable? 100 years of lessons learned. American Journal of Public Health, 90(10), 1515.
Bailey, T. C., Merritt, M. W., & Tediosi, F. (2015). Investing in justice: ethics, evidence, and the eradication investment cases for lymphatic filariasis and onchocerciasis. American journal of public health, 105(4), 629-636.
Beigbeder, Y. (2017). The World Health Organization: Achievements and Failures. Routledge.
Browne, C. J., Smith, R. J., & Bourouiba, L. (2015). From regional pulse vaccination to global disease eradication: insights from a mathematical model of poliomyelitis. Journal of mathematical biology, 71(1), 215-253.
Foul Water Fiery Serpent, 2016. Retrived from: https://youtu.be/THWLBNvCQm0?t=126Newby, G., Bennett, A., Larson, E., Cotter, C., Shretta, R., Phillips, A. A., & Feachem, R. G. (2016). The path to eradication: a progress report on the malaria-eliminating countries. The Lancet, 387(10029), 1775-1784.