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There is increasing evidence that elimination strategies have resulted in better outcomes for public health, the economy, and civil liberties than have mitigation strategies throughout the first year of the COVID-19 pandemic. With vaccines that offer high protection against severe forms of COVID-19, and increasing vaccination coverage, policy makers have had to reassess the trade-offs between different options. The desirability and feasibility of eliminating SARS-CoV-2 compared with other strategies should also be re-evaluated from the perspective of different fields, including epidemiology, public health, and economics. To end the pandemic as soon as possible-be it through elimination or reaching an acceptable endemic level-several key topics have emerged centring around coordination, both locally and internationally, and vaccine distribution. Without coordination it is difficult if not impossible to sustain elimination, which is particularly relevant in highly connected regions, such as Europe. Regarding vaccination, concerns remain with respect to equitable distribution, and the risk of the emergence of new variants of concern. Looking forward, it is crucial to overcome the dichotomy between elimination and mitigation, and to jointly define a long-term objective that can accommodate different political and societal realities., Competing Interests: Declaration of interests MGB is a member of the New Zealand Ministry of Health's COVID-19 technical advisory group and took a leading role in formulating New Zealand's elimination strategy. AF is a member of the French COVID-19 Scientific Council, and a member of the French COVID-19 Vaccine Strategy Committee. GBW is a member of the G20 High Level Independent Panel on Financing the Global Commons for Pandemic Preparedness and Response. JVL is a member of the Lancet COVID-19 Commission Public Health Taskforce. All other authors declare no competing interests. Editorial note: the Lancet Group takes a neutral position with respect to territorial claims in published text., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)