title: The role of research in viral disease eradication and elimination programs: lessons for malaria eradication.
abstract: By examining the role research has played in eradication or regional elimination initiatives for three viral diseases--smallpox, poliomyelitis, and measles--we derive nine cross-cutting lessons applicable to malaria eradication. In these initiatives, some types of research commenced as the programs began and proceeded in parallel. Basic laboratory, clinical, and field research all contributed notably to progress made in the viral programs. For each program, vaccine was the lynchpin intervention, but as the programs progressed, research was required to improve vaccine formulations, delivery methods, and immunization schedules. Surveillance was fundamental to all three programs, whilst polio eradication also required improved diagnostic methods to identify asymptomatic infections. Molecular characterization of pathogen isolates strengthened surveillance and allowed insights into the geographic source of infections and their spread. Anthropologic, sociologic, and behavioural research were needed to address cultural and religious beliefs to expand community acceptance. The last phases of elimination and eradication became increasingly difficult, as a nil incidence was approached. Any eradication initiative for malaria must incorporate flexible research agendas that can adapt to changing epidemiologic contingencies and allow planning for posteradication scenarios.
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, Maryland, United States of America.
authors.forename: Joel G
authors.initials: JG
authors.lastname: Breman
authors.forename: Ciro A
authors.initials: CA
authors.lastname: de Quadros
authors.forename: Walter R
authors.initials: WR
authors.lastname: Dowdle
authors.forename: William H
authors.initials: WH
authors.lastname: Foege
authors.forename: Donald A
authors.initials: DA
authors.lastname: Henderson
authors.forename: T Jacob
authors.initials: TJ
authors.lastname: John
authors.forename: Myron M
authors.initials: MM
authors.lastname: Levine
mesh_terms: D000349:Africa / Q000453:epidemiology; D000569:Americas / Q000453:epidemiology; D000818:Animals; D003140:Communicable Disease Control / Q000458:organization & administration* / Q000639:trends; D014943:Global Health; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D017780:Malaria Vaccines; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control; D008962:Models, Theoretical; D017720:Molecular Epidemiology; D009032:Mosquito Control; D011051:Poliomyelitis / Q000453:epidemiology / Q000517:prevention & control; D011057:Politics; D011159:Population Surveillance; D012106:Research; D012899:Smallpox / Q000453:epidemiology / Q000517:prevention & control; D012959:Socioeconomic Factors; D014765:Viral Vaccines; D014777:Virus Diseases / Q000517:prevention & control*; D014944:World Health Organization
chemical_list: D017780:Malaria Vaccines; D014765:Viral Vaccines