United States, building
Measles elimination, and its erosion
The United States eliminated endemic measles transmission by 2000 through school-entry vaccination requirements, and falling coverage brought 2,777 confirmed cases by August 2026, the most since 1991, against 285 in all of 2024.
2,777 cases, confirmed measles cases in 2026, to 20 august, 2026-08. 285 cases, confirmed measles cases in the last pre-outbreak year, 2024. US Centers for Disease Control and Prevention, measles cases and outbreaks, retrieved 2026-08-27.
The move, and what it needed
The erosion is the mechanism recorded here: vaccination requirements are enforced at school entry by states, so a delivery that took federal purchasing and decades of practice is being undone state by state through widening exemption rules and falling trust, with no single decision anywhere.
Preconditions
- Enforcement located at fifty state legislatures rather than one national rule
- A generation of parents with no memory of the disease
- An information environment that carries vaccine doubt faster than health agencies answer it
Where it travelled: The same coverage decline is visible across several high-income countries; the American case is the cleanest because elimination was formally certified in 2000, which fixes the baseline the erosion is measured against.
Limits: A case count is the lagging end of the erosion; the leading end is kindergarten vaccination coverage, which CDC reports separately as falling from about 95 percent before the pandemic to under 93 percent, below the outbreak-prevention threshold. The 2026 number is a year in progress and will rise. Elimination status is a WHO-defined property of transmission chains, not of case counts, and had not been formally revoked at retrieval; what the record documents is a maintained public-health achievement being lost while the infrastructure that delivered it still exists.
This record describes what United States delivered. It is linked to Large project delivery because no comparable dataset measures that capability. It does not affect the score or confidence.
The same gap elsewhere
17 deliveries linked to Large project delivery in other countries.
Brazil's central bank specified, built and ran a mandatory instant payment rail that settled 7.98 billion transactions in July 2026, for 152 million people and 14 million firms transacting in that month.
GOV.BR federal identity and service platform
Brazil consolidated federal public services behind one identity platform, reporting 175 million active accounts and 5,179 digital services in May 2026.
X-Road national data exchange layer
Estonia has run one data exchange layer for the whole state since 2001, and in July 2026 it carried 374.9 million queries between 1,000 connected organizations, 251 of them government bodies, across 3,785 services.
Pradhan Mantri Jan Dhan Yojana bank accounts
India opened 590.9 million basic bank accounts through existing banks from 2014, holding 3.17 lakh crore rupees in deposits as of 19 August 2026.
Electricity supply rebuilt on renewable sources
Uruguay rebuilt its electricity supply between 2010 and 2017 through public tenders and long-term contracts, and in 2025 fossil fuels produced 293 GWh of the 15,855 GWh generated, so 98.2 percent came from hydro, wind, biomass and solar.
Plan Ceibal, one connected laptop per child
Uruguay gave a connected laptop to every child in public primary school from 2007, the first country to do it nationally, and the household survey found a Ceibal computer in the homes of 35.8 percent of the population in 2018.
Sistema Unico de Saude, universal public health system
Brazil wrote a right to health into the 1988 constitution and built a single public system that covers everybody in the country, and the WHO service coverage index for Brazil rose from 71 in 2000 to 84 in 2023.
Programa Nacional de Imunizacoes, and its erosion
Brazil's national immunisation programme reached 99 percent DPT coverage in 2003 and held above 95 percent for a decade, then fell to 68 percent by 2021 and had recovered to 91 percent by 2024.
Luz para Todos, rural electrification
Brazil connected the last rural households to electricity through a national programme run with the state and private distributors, taking access from 94.4 percent of the population in 2000 to 99.8 percent in 2024.
Bolsa Familia and the single registry behind it
Brazil built one national registry of low-income households and paid conditional transfers through it, going from 6.6 million benefits in December 2004 to a peak of 21.0 million in 2022 and 18.6 million in December 2025.
Fully electronic national elections
Brazil has run every election on electronic voting machines since 2000, across an electorate that reached 155.9 million voters in 2024, with results published the same evening.
Deepwater and pre-salt oil production
Brazil developed deepwater extraction, found the pre-salt fields in 2006 and produced them at depths of more than 5,000 metres, with national oil production rising from 71,844 thousand cubic metres in 2000 to 219,032 in 2025.
Seguro Popular, and its abolition
Mexico built public health insurance for people outside social security from 2003 and abolished it in 2020, and CONEVAL measured the share of the population without access to health services rising from 16.2 percent in 2018 to 39.1 percent in 2022.
Sure Start children's centres, and their erosion
England built a national network of early-childhood centres reaching 3,632 sites by August 2009, then closed or hollowed out a large part of it after funding was cut, with the official count at 3,123 by October 2017 and independent estimates near 1,000 closures.
South Africa ran one of the world's cheapest reliable grids and extended it to most of the population after 1994, then under-invested and lost the surplus, reaching 335 days of load shedding in 2023 before recovering to 83 days in 2024.
BNDES, the national development bank
Founded in 1952, Brazil's federal development bank provides long-term financing and investment across the national economy, and it disbursed R$169.7 billion in 2025.
Casa da Moeda do Brasil, the national mint
Founded in 1694, Brazil's national mint has remained a public institution through colonial, imperial and republican regimes and now produces currency, identity documents and passports after more than 330 years of operation.