From smallpox eradication to contemporary global health initiatives: Enhancing human capacity towards a global public health goal

Tarantola, Daniel; Foster, Stanley O.

doi:10.1016/j.vaccine.2011.07.027

Cited by 11 publications

(10 citation statements)

References 7 publications

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“…NPT preparedness and implementation science studies are needed to explore product acceptability and evaluate interventions in real-world settings in order to facilitate the translation of technological advances into everyday use [ 25 – 27 ]. Such investigations are desirable well before NPT products are ready for dissemination, to promote the most comprehensive understanding of the “preconditions for their demand, acceptance and use by communities” [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study

et al. 2018

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BackgroundNew biomedical prevention technologies (NPTs) may contribute to substantially reducing incident HIV infections globally. We explored acceptability and preferences for NPTs among key and other vulnerable populations in two South African townships.MethodsWe conducted six focus groups and 12 in-depth interviews with adolescents, and adult heterosexual men, women, and men who have sex with men (MSM) (n = 48), and eight in-depth interviews with key informant healthcare workers. The interview guide described pre-exposure prophylaxis (PrEP), vaginal rings, rectal microbicides and HIV vaccines, and explored acceptability and product preferences. Focus groups and in-depth interviews (45–80 minutes) were conducted in Xhosa, audiotaped, and transcribed and translated into English. Data were coded and reviewed using framework analysis with NVivo software.ResultsOverall, initial enthusiasm and willingness to use NPTs evolved into concerns about how particular NPTs might affect or require alterations in one’s everyday lifestyle and practices. Different product preferences and motivations emerged by population based on similarity to existing practices and contexts of vulnerability. Adult women and female adolescents preferred a vaginal ring and HIV vaccine, motivated by longer duration of protection to mitigate feared repercussions from male partners, including threats to their marriage and safety, and a context of ubiquitous rape. Male adolescents preferred an HIV vaccine, seen as protection in serodiscordant relationships and convenient in obviating the HIV stigma and cost involved in buying condoms. Adult men preferred PrEP, given familiarity with oral medications and mistrust of injections, seen as enabling serodiscordant couples to have a child. MSM preferred a rectal microbicide given familiarity with gel-based lubricants, with concerns about duration of protection in the context of unplanned consensual sex and rape.ConclusionsBiomedical interventions to prevent HIV transmission, rather than obviating social-structural factors that produce vulnerability, may be limited by these same factors. Implementation of NPTs should engage local communities to understand real-world constraints and strategise to deliver effective, multi-level combination prevention.

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Section: Introductionmentioning

confidence: 99%

Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study

et al. 2018

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“…Some commentators note that the narrow focus on smallpox was sometimes counterproductive given the range of health issues afflicting communities. In Bangladesh, for example, vaccination occurred in the midst of a cholera epidemic, yet the vaccinators could provide no assistance with the more visible and urgent problem, resulting in community frustration [68]. As the programme proceeded, additional components were therefore added onto the responsibilities of surveillance agents to keep them engaged and motivated despite the infrequency with which smallpox was observed, including surveys investigating access to clean water, vitamin A, family planning, and rates of childhood mortality [68].…”

Section: Resultsmentioning

confidence: 99%

“…In Bangladesh, for example, vaccination occurred in the midst of a cholera epidemic, yet the vaccinators could provide no assistance with the more visible and urgent problem, resulting in community frustration [68]. As the programme proceeded, additional components were therefore added onto the responsibilities of surveillance agents to keep them engaged and motivated despite the infrequency with which smallpox was observed, including surveys investigating access to clean water, vitamin A, family planning, and rates of childhood mortality [68]. Similarly, malaria-only health workers may prove less successful than those that have been trained to treat a variety of common illnesses [69].…”

Section: Resultsmentioning

confidence: 99%

“Remarkable solutions to impossible problems”: lessons for malaria from the eradication of smallpox

Cohen

2019

Malar J

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Background Malaria elimination and eventual eradication will require internationally coordinated approaches; sustained engagement from politicians, communities, and funders; efficient organizational structures; innovation and new tools; and well-managed programmes. As governments and the global malaria community seek to achieve these goals, their efforts should be informed by the substantial past experiences of other disease elimination and eradication programmes, including that of the only successful eradication programme of a human pathogen to date: smallpox. Methods A review of smallpox literature was conducted to evaluate how the smallpox programme addressed seven challenges that will likely confront malaria eradication efforts, including fostering international support for the eradication undertaking, coordinating programmes and facilitating research across the world’s endemic countries, securing sufficient funding, building domestic support for malaria programmes nationally, ensuring strong community support, identifying the most effective programmatic strategies, and managing national elimination programmes efficiently. Results Review of 118 publications describing how smallpox programmes overcame these challenges suggests eradication may succeed as a collection of individual country programmes each deriving local solutions to local problems, yet with an important role for the World Health Organization and other international entities to facilitate and coordinate these efforts and encourage new innovations. Publications describing the smallpox experience suggest the importance of avoiding burdensome bureaucracy while employing flexible, problem-solving staff with both technical and operational backgrounds to overcome numerous unforeseen challenges. Smallpox’s hybrid strategy of leveraging basic health services while maintaining certain separate functions to ensure visibility, clear targets, and strong management, aligns with current malaria approaches. Smallpox eradication succeeded by employing data-driven strategies that targeted resources to the places where they were most needed rather than attempting to achieve mass coverage everywhere, a potentially useful lesson for malaria programmes seeking universal coverage with available tools. Finally, lessons from smallpox programmes suggest strong engagement with the private sector and affected communities can help increase the sustainability and reach of today’s malaria programmes. Conclusions It remains unclear whether malaria eradication is feasible, but neither was it clear whether smallpox eradication was feasible until it was achieved. To increase chances of success, malaria programmes should seek to strengthen programme management, measurement, and operations, while building flexible means of sharing experiences, tools, and financing internationally.

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“…The principles of eradication of an infectious disease rely on four factors: biologic feasibility, adequate public health infrastructure, funding, and sustained political and societal will (Dowdle and Cochi 2011;Hopkins 2013;Tarantola and Foster 2011). Global decisions on disease eradication require consideration of prioritization and costs in order to achieve the most appropriate, cost-beneficial, and equitable outcome of disease control (Dowdle and Cochi 2011;Hopkins 2013).…”

Section: Elimination/control Approaches In the Americasmentioning

confidence: 99%

“…Global decisions on disease eradication require consideration of prioritization and costs in order to achieve the most appropriate, cost-beneficial, and equitable outcome of disease control (Dowdle and Cochi 2011;Hopkins 2013). In addition, other conditions need to be met such as a disease with a straightforward diagnosis, low transmissibility, and ability to distinguish between current and past infection (Lockwood et al 2014;Tarantola and Foster 2011). There is also limited availability of diagnostic tools for early diagnosis of the disease (White and Franco-Paredes 2015).…”

Section: Elimination/control Approaches In the Americasmentioning

confidence: 99%

Neglected Tropical Diseases - Latin America and the Caribbean

Franco‐Paredes¹,

Santos-Preciado²

2015

Neglected Tropical Diseases

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From smallpox eradication to contemporary global health initiatives: Enhancing human capacity towards a global public health goal

Cited by 11 publications

References 7 publications

Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study

Contexts of vulnerability and the acceptability of new biomedical HIV prevention technologies among key populations in South Africa: A qualitative study

“Remarkable solutions to impossible problems”: lessons for malaria from the eradication of smallpox

Neglected Tropical Diseases - Latin America and the Caribbean

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