The Mediterranean fruit fly, Ceratitis capitata (Wiedemann) (Diptera: Tephritidae), is considered one of the most important pests worldwide because of its direct damage to fruit and vegetable production, and restrictions imposed to commercialization of horticultural commodities by countries free of the pest. It was introduced to Brazil in 1901 and to Costa Rica in 1955, from where it spread across the Central American region, reaching Guatemala and Mexico in 1976 and 1977, respectively. In response, the governments of Guatemala, Mexico, and the USA joined efforts to (1) contain further northward spread of the pest, (2) eradicate it from the areas it had invaded in southern Mexico, and (3) in the longer term eradicate it from Guatemala and eventually from the rest of Central America. To this effect, cooperative agreements were subscribed between the three countries and also between the USA and Belize. This allowed regional cooperation against the Mediterranean fruit fly and the creation of the Moscamed Programme. The programme was the first area‐wide large‐scale application of the sterile insect technique (SIT) against this pest. By 1982, the Programme had achieved its first two objectives with the containment of the northward advance of the pest, and its eradication from the areas it had invaded in the states of Chiapas and Oaxaca in southern Mexico. Furthermore, by 1985 the Mediterranean fruit fly had been eradicated from areas in Guatemala located at the border with Mexico. Since then, the programme has had years with significant territorial advances in the eradication of the pest from areas within Guatemala, combined with years when it had setbacks resulting in losses of the territorial gains. Nevertheless, during 4 decades, the programme has effectively served as an effective containment barrier maintaining the Mediterranean fruit fly‐free status of Belize, Mexico, and the USA. It has also protected and increased the Mediterranean fruit fly‐free areas in Guatemala. As a result, it has protected the assets of horticultural producers and contributed during this period to the development of multibillion dollar export industries in these countries. This paper provides an historical review of the programme and describes briefly how technological innovations and decision‐making tools have contributed to programme efficiency. It also discusses how non‐technical and external factors have limited the eradication process and further programme advance within the Central American region.

(1) Background: in epidemiological terms, it has been possible to calculate the savings in health resources and the reduction in health effects of COVID vaccines. From the point of view of economic evaluation, some studies have estimated its cost-effectiveness with the vaccination showing highly favorable results, which in some cases is cost-saving; (2) Methods: a cost-benefit analysis of the vaccination campaign in the North Metropolitan Health Region (Catalonia). An epidemiological model based on observational data and before and after comparison is used. The information on the doses used and the resources assigned (conventional hospital beds, ICU, number of tests) has been extracted from administrative data from the largest Primary Care provider in the region (Catalan Institute of Health). A distinction is made between the social perspective and the health system; (3) Results: the costs of vaccination are estimated at 137 million euros (€48.05/dose administered). This figure is significantly lower than the positive impacts of the vaccination campaign, which are estimated at 470 million euros (€164/dose administered). Of these, 18% corresponds to the reduction of ICU discharges, 16% to the reduction in conventional hospital discharges, 5% to the reduction in PCR tests and 1% to the reduction of RAT tests. Monetization of deaths and cases with sequelae avoided account for 53% and 5% of total savings, respectively. The benefit/cost ratio is estimated at 3.4 from a social perspective and 1.2 from a health system perspective. The social benefits of vaccination are estimated at €116.67 per dose of vaccine given (€19.93 from the point of view of the health system); (4) Conclusions: the mass vaccination campaign against COVID is cost-saving. From a social perspective, most of these savings come from the monetization of the reduction in mortality and cases with sequelae, although the intervention is equally widely cost-effective from the point of view of the health system thanks to the reduction in the use of resources. It is concluded that, from an economic perspective, the vaccination campaign has high social returns.