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Two days after the 30th anniversary of the eradication of smallpox, 30 scientists and public health experts from around the world gathered for a weeklong meeting in the German city of Frankfurt am Main to try to chart a new path for disease eradication in the 21st century. Their meeting was triggered by several developments. Interest in tackling global health problems has surged the past decade, as has funding, but the two ongoing eradication campaigns—against guinea worm disease and polio—have proven far more difficult than predicted. Meanwhile, a key rationale for past eradication efforts—the promised financial windfall from stopping all control measures once a disease is gone—all but disappeared as a result of 9/11 and the 2001 anthrax letters. Wealthy countries in particular are determined never to let their guard down against diseases like smallpox, polio, or measles. Meanwhile, developing countries have their own questions: Why should they keep spending inordinate amounts of time and money on a disease such as polio—now down to fewer than 2000 cases a year—while their health systems are struggling with far more devastating diseases such as AIDS and TB?