Humanity has only ever eradicated two diseases (and one of those, rinderpest, is only in cattle not humans). The next disease on the list is probably Guinea worm (though polio is also tantalizingly close).
At its peak Guinea worm infected ~900k people a year. In 2024 we so far only know of 7 cases. The disease isn’t deadly, but it causes significant pain for 1-3 weeks (as a worm burrows out of your skin!) and in ~30% of cases that pain persists afterwards for about a year. In .5% of cases the worm burrows through important ligaments and leaves you permanently disabled. Eradication efforts have already saved about 2 million DALYs.[1]
I don’t think this outcome was overdetermined; there’s no recent medical breakthrough behind this progress. It just took a herculean act of international coordination and logistics. It took distributing millions of water filters, establishing village-based surveillance systems in thousands of villages across multiple countries, and meticulously tracking every single case of Guinea worm in humans or livestock around the world. It took brokering a six-month ceasefire in Sudan (the longest humanitarian ceasefire in history!) to allow healthcare workers to access the region. I’ve only skimmed the history, and I’m generally skeptical of historical heroes getting all the credit, but I tentatively think it took Jimmy Carter for all of this to happen.
Rest in peace, Jimmy Carter.
- ^
I’m compelled to caveat that top GiveWell charities are probably in the ballpark of $50/DALY, and the Carter Center has an annual budget of ~$150 million a year, so they “should” be able to buy 2 million DALYs every single year by donating to more cost-effective charities. But c’mon this worm is super squicky and nearly eradicating it is an amazing act of agency.
I assume “let’s think step by step” is a joke/on purpose. The “first” and “not so fast” on their own don’t seem that egregious to me.