Eradication: Ridding the World of Diseases Forever?

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How shall we improve human health? One answer is: by eradication. The Gates Foundation announced in 2007 that their goal is malaria eradication; another of their priorities is polio eradication. Eradication means the complete elimination of a disease through deliberate human intervention. It stands for an absolute in public health.

This book by the award-winning historian of medicine Nancy Leys Stepan is an accessible, beautifully written, and deeply researched examination of one of the most controversial issues in public health today. The eradication of disease might seem like an absolute good. But critics of eradication argue that the huge resources needed to achieve eradication could be better allocated toward developing primary health services and general improvement in health.

This book aims to look at the benefits and drawbacks of single-minded efforts to rid the world of particular diseases, one at a time. The sweep of the book is impressive, from the origins of the idea of complete eradication in the early twentieth century until the present-day campaigns against polio, Guinea worm disease, and now malaria. The author places eradication's story in its many contexts, from imperialism, changing notions of public health, the history of medicine and its technologies, the development of international health agencies such as the World Health Organization, and the impact of the Cold War on the shift of attention to disease in developing countries.

At the center of this narrative is Dr. Fred Lowe Soper (1893–1977), a U.S.-trained doctor who became the arch-eradicationist of his time. His campaigns to eradicate hookworm disease, yaws, yellow fever, malaria, and smallpox are treated in compelling detail, as are the roles of international health agencies such as the Rockefeller Foundation and the World Health Organization.

Throughout the book Stepan draws attention to the way that the ideal of eradication has repeatedly arisen, phoenix-like, from its setbacks. In a powerful conclusion, she uses the example of the current campaign to eradicate Guinea worm disease to argue that, today, under the right circumstances, eradication and primary health care need not be in conflict, as they were in the past, but can form mutually reinforcing policies to improve the health and well-being of populations, especially the poorest and most disease-burdened populations of the world.

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Editorial Reviews

From the Publisher

"Do focused disease eradication attempts or more broadly based primary health-care efforts produce better results? Stepan discusses this question in light of today's more foundation-driven public-health world, including the Gates Foundation's declared goal to eradicate malaria. Her conclusion is that 'eradication efforts should be exceptional and rare.' For those working in or interested in public health, this book offers a well-documented look at both the history and the current challenges of eradication."—Library Journal

Helen Tilley

"It would be difficult to overestimate the value of this book. Clearly written and persuasively argued, Eradication should be required reading for anyone interested in global health past or present. Nancy Leys Stepan provides not only a significant account of the history of eradication but also deeper insight into the history of international health institutions, imperial and Cold War politics, medical funding and philanthropies, and the globalization of biomedicine. Because Stepan writes so accessibly and weds her analysis to astute contemporary commentary, her book speaks to multiple audiences, including practitioners themselves."—Helen Tilley, historian of medicine and author of Africa as a Living Laboratory: Empire, Development, and the Problem of Scientific Knowledge, 1870–1950

Steven Palmer

"It is very important finally to have a history of eradication, especially one of such quality and comprehensiveness that considers local, national, and international experiences. Nancy Leys Stepan is a celebrated scholar who has conducted pathbreaking research on malaria, yellow fever, and smallpox. To eradicate or not to eradicate has been and continues to be an issue of central concern in global health. Stepan's history forces us to ask, is it politically wise and socially useful and just to eradicate disease and, if so, what conditions and past experiences must we take into account in deciding which diseases to tackle?"—Steven Palmer, Canada Research Chair in History of International Health, University of Windsor

Library Journal
The question mark at the end of this book's subtitle sets the tone for the approach Stepan (history, emeritus, Columbia Univ.; "The Hour of Eugenics") takes throughout. While disease eradication has often been a stated goal of public-health efforts, it has been achieved only once—in the case of smallpox. Stepan frames her story with the career of Fred Soper, an "arch-eradicationist." The first eradication efforts mirrored Soper's top-down focus on a single disease with tight control over the process by organizations such the Rockefeller Foundation. Complete eradication proved elusive, and questions gradually arose over whether focused eradication attempts or more broadly based primary health-care efforts produced better results. The question still lingers, and Stepan discusses today's more foundation-driven public-health world, including the Gates Foundation's declared goal to eradicate malaria. Her conclusion is that "eradication efforts should be exceptional and rare." VERDICT For those working in or interested in public health, this book offers a well-documented look at both the history and the current challenges of eradication.—Dick Maxwell, Porter Adventist Hosp. Lib., Denver
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Product Details

  • ISBN-13: 9780801450587
  • Publisher: Cornell University Press
  • Publication date: 9/29/2011
  • Pages: 312
  • Sales rank: 1,419,195
  • Product dimensions: 6.20 (w) x 8.80 (h) x 1.30 (d)

Meet the Author

Nancy Leys Stepan is Professor Emeritus of History at Columbia University. She is the author of Eradication, "The Hour of Eugenics": Race, Gender, and Nation in Latin America and Picturing Tropical Nature, all from Cornell.

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Table of Contents

1. Eradication and Public Health
2. Imperial Origins
3. Paradoxes: The Rockefeller Era
4. Post-war: A Capacity for Fanaticism
5. The End of Malaria in the World?
6. The Last Inch: Smallpox Eradication
7. Controversies: Eradication Today

Select Bibliography
Photo Acknowledgements

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