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World Development Report 1993: endemic I wanted to know more. I reached out to Dr. Bill Foege, one of the epidemiologists responsible for the eradication of smallpox and a former head of the Centers for Disease Control and Prevention. Bill gave me a stack of eighty-one textbooks and journal articles on smallpox, malaria, and public health in poor countries; I read them as fast as I could and asked for more. One of the most influential for me had a mundane title: World Development Report 1993: Investing in Health, Volume 1.3 My obsession with infectious diseases--and particularly infectious diseases in the developing world--had begun. When you start reading up on infectious diseases, it isn't long before you come to the subject of outbreaks, epidemics, and pandemics. There aren't strict definitions for these terms; a good rule of thumb is that an outbreak is when a disease spreads locally, through a community or small region, an epidemic is when an outbreak goes national, and a pandemic is when an epidemic goes global, affecting more than one continent. And some diseases don't come and go, but stay consistently in a specific location--those are known as endemic diseases. Malaria is endemic to many equatorial regions. If COVID-19 never goes away completely, it'll be classified as an endemic disease. <~?~Insert art 002_Gate_9780593534489_art_r1> <~?~NO CAPTION FOR ABOVE ILLUSTRATION (Illustration comparing the classifications of outbreaks, epidemics, and pandemics.)> In 1969, the surgeon general of the United States announced that it was "time to close the book on the problem of infectious diseases." Yet since then, according to the World Health The Gates Foundation helped fund this work and the vaccine's distribution to children in low- and middle-income countries.