Target Zero: Why States Choose To Eradicate Infectious Diseases And How They Succeed

Gifty Abraham, City University of New York, Graduate Center

Abstract

Realism has remained the dominant paradigm within international relations for most of the modern era, emphasizing the competitive nature of the international arena and the unlikeliness of states to within it to cooperate. The attempts and further still, successes, by states to eradicate infectious diseases--which remain among the most cooperative enterprises--present a number of challenges to realism's assumptions, particularly with respect to the unlikely world historical-times during which the eradication campaigns took place. As such, a two-part puzzle arises. First, why would states, which are natural competitors, cooperate to eradicate infectious diseases given structural and situational incentives not to do so? Second, when states choose to eradicate infectious diseases, what accounts for success? I tackle these questions in turn, proposing three factors: reputational benefits, rational self-interest, and the interplay of state and non-state actors, all of which, in addition to international institutions help explain the involvement and cooperation of state actors in eradication efforts, particularly at those critical periods. To answer the second question, I offer a five-point rubric which features necessary, if insufficient conditions for the success of any eradication campaign. They are: ways to cure, treat or manage the disease and its spread; monitoring programs; political will; community engagement; and agencies tasked, and adequately equipped to deal with the disease. I answer the proposed questions and apply both sets of factors using three case studies; they include the successful case of smallpox eradication, the first failed campaign against malaria of the 1950s and the modern ongoing effort, and the campaign against guinea worm disease today.