Towards the endgame and beyond: Complexities and challenges for the elimination of infectious diseases

Petra Klepac, C. Jessica E. Metcalf, Angela R. McLean, Katie Hampson

Research output: Contribution to journalArticlepeer-review

95 Scopus citations


Successful control measures have interrupted the local transmission of human infectious diseases such as measles, malaria and polio, and saved and improved billions of lives. Similarly, control efforts havemassively reduced the incidence of many infectious diseases of animals, such as rabies and rinderpest, with positive benefits for human health and livelihoods across the globe. However, disease elimination has proven an elusive goal,with only one human and one animal pathogen globally eradicated. As elimination targets expand to regional and even global levels, hurdles may emerge within the endgame when infections are circulating at very low levels, turning the last mile of these public health marathons into the longest mile. In this theme issue, we bring together recurring challenges that emerge as we move towards elimination, highlighting the unanticipated consequences of particular ecologies and pathologies of infection, and approaches to their management.

Original languageEnglish (US)
JournalPhilosophical Transactions of the Royal Society B: Biological Sciences
Issue number1623
StatePublished - Aug 2013
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • General Biochemistry, Genetics and Molecular Biology
  • General Agricultural and Biological Sciences


  • Immune escape
  • Susceptible build-up
  • Vaccination coverage
  • Vaccine refusal


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