Eradication and elimination programs are considered the natural corollary of disease control programs. It is often the case that global or regional goals are missed several times. Deconstruction of the global programs has unraveled that the initial program theories can be inadequate and partial, and programs are often required to make definitional and tactical shifts. Social and political determinants are well established but are rarely foregrounded in terms of program formulation and often receive adequate resources and inputs. The World Health Organization (WHO) is now seeking to move towards a multidisease elimination (MDE) approach and advocating a “people-centered approach” to achieving these with greater efficiency, effectiveness, and equity. We call for a greater measure of social compact beyond the mere task of shifting to the community health workers (CHWs) and the community.