In the 1980s, why was polio, with its rather small mortality rate, chosen for a worldwide “eradication” campaign, when other infectious diseases such as measles, pneumonia, and diarrhoea causing infections each killed millions of children a year? It had little to do with the priorities of most developing countries where polio was endemic. It was more to do with the ideology of a small number of powerful and well placed players in global public health who were dedicated to the concept of so called eradication as perhaps the major tool for international public health.1

Many of these people had been involved in the successful campaign to eradicate smallpox. However, after that great achievement near consensus had formed in public health circles that primary healthcare (including routine immunisation) rather than vertical eradication campaigns should be the focus of global and national efforts. It looked as though smallpox would be the first and last human disease to be eradicated.

Those who I would call “eradicationists” had to find a disease that could be quickly …