The Initiative recently released a draft of their 2013–2018 Endgame Strategic Plan. The entire report is good reading, but I found this diagram particularly interesting:

Figure 20. GPS tracking of vaccinators, November 2012Kasurawa A village, Sokoto state [Nigeria]. Each yellow dot represents one track collected every two minutes. Density of dots is converted into an algorithm to approximate the percentage of geographic area visited by the team. In this graph, more than 50% of the village was not visited.

In the world of disease eradication the “final inch” between near eradication and complete eradication is the hardest. If even a small area isn’t vaccinated, it can create a pocket from which the disease can spring back into a larger cluster of cases.

Going door-to-door in these villages must be hard, tedious work. I can easily imagine a vaccinator claiming that they covered the whole village when, in fact, they did not. The whole multi-billion dollar Polio eradication effort could hinge on whether villages like Kasurawa A are fully or just partially vaccinated.

The GPS trackers are a clever way of doing quality control. It’s hard to argue against concrete evidence like the picture above. In the context of disease eradication, “technology” usually means new vaccines or an improved cold chain. But IT can play a role, too.