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.
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 don't think you need that footnoted caveat, simply because there isn't $150M/year worth of room for more funding in all of AMF, Malaria Consortium's SMC program, HKI's vitamin A supplementation program, and New Incentives' cash incentives for routine vaccination program all combined; these comprise the full list of GiveWell's top charities.
Another point is that the benefits of eradication keep adding up long after you've stopped paying for the costs, because the counterfactual that people keep suffering and dying of the disease is no longer happen... (read more)